Northwest Care-Shoreline, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1351 Issued in WA

Legal business name

NORTHWEST CARE-SHORELINE, INC.

Doing business as

Park Ridge Care Center

Practice address

1250 NE 145TH St
Shoreline, WA 98155-7134

Phone

(206) 363-5856

NPI assigned

Dec 9, 2005

Last updated

Apr 5, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marc Johnson

Title

Chief Fiancial Officer

Phone

(949) 373-8373

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PARK RIDGE CARE CENTER Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712275200000",
    "number": "1285619577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25910 ACERO STE 350",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926917908",
            "telephone_number": "949-441-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 NE 145TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981557134",
            "telephone_number": "206-363-5856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST CARE-SHORELINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CHIEF FIANCIAL OFFICER",
        "authorized_official_telephone_number": "949-373-8373"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113510",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARK RIDGE CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PARK RIDGE CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Shoreline, WA
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• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.