Active NPI
Alemayehu Woldegeorgis
- Adult Care Home Facility
- Marysville, WA
National Provider Identifier
1306755046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- 758681
- Practice address
- 4912 89TH PL NE Unit B
Marysville, WA 98270-2533 - Phone
- (425) 439-5818
- Fax
- (425) 740-0237
- NPI assigned
- Sep 7, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | 758681 | WA | Primary |
Addresses
Primary practice location
4912 89TH PL NE Unit B
Marysville, WA 98270-2533
Mailing address
4912 89TH PL NE Unit B
Marysville, WA 98270-2533
Phone (425) 439-5818
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788739200000",
"number": "1306755046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4912 89TH PL NE UNIT B",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982702533",
"telephone_number": "425-439-5818",
"fax_number": "425-740-0237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4912 89TH PL NE UNIT B",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982702533",
"telephone_number": "425-439-5818",
"fax_number": "425-740-0237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLDEGEORGIS",
"first_name": "ALEMAYEHU",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-07",
"last_updated": "2026-09-07",
"certification_date": "2026-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "WA",
"license": "758681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.