NPIMap

Organization Active NPI

Presbyterian Retirement Communities Northwest

  • Skilled Nursing Facility
  • Seattle, WA
National Provider Identifier
1306834627
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH602 Issued in WA
Legal business name
PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST
Doing business as
Skyline at First Hill
Practice address
715 9TH Ave
Seattle, WA 98104-2066
Phone
(206) 826-2120
Fax
(206) 826-2110
NPI assigned
Oct 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

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

Authorized official

Name
Mr. Frederick M Kellegrew
Title
President & Ceo
Phone
(206) 826-2126

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X BH213 WA
Skilled Nursing Facility 314000000X NH602 WA Primary

Addresses

Primary practice location

715 9TH Ave
Seattle, WA 98104-2066

Mailing address

715 9TH Ave
Suite 400
Seattle, WA 98104-2066
Phone (206) 826-2120

Other identifiers 1

IdentifierTypeStateIssuer
4160206MedicaidWA

Other names 1

  • Skyline at First Hill Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091119000638 WA Part A Provider - Skilled Nursing Facility 8224177829 Practice locations: Seattle, WA

Skilled nursing facility certification: CCN 505469

Legal name
PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST
Doing business as
TERRACES AT SKYLINE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 16, 1992
Last certification
Aug 23, 2024
Beds
34
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Transforming Age
Organization structure
CorporationNon-profit
Incorporated
Jul 12, 1956 in WA
Enrollment address
715 9TH Ave
Seattle, WA 98104-2066
Nursing home name
THE TERRACES AT SKYLINE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Terraces at SkylineCCN 505469 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 16, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3428.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2000192The Terraces at Skyline715 9TH Ave, Seattle, WA 98104Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Exter House2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Douglas S Diekema Individual OtherBoard of Directors Jun 1, 2009
Gary Houlahan Individual OtherBoard of Directors Jun 1, 2006
Carole Conger Individual OtherBoard of Directors Jun 1, 2007
Justin Miedema Individual OtherBoard of Directors Jun 1, 2013
James I Melhorn Individual OtherBoard of Directors Jun 1, 2008
James Bennett Individual Corporate DirectorHealth Services Director Apr 1, 2014
Paula Fitzgerald Boos Individual OtherBoard of Directors Jun 1, 2012
Thomas Vasilatos Individual OtherBoard Member Jun 1, 2010
Kevin McNamara Individual Corporate DirectorExecutive Director Sep 3, 2013
Bonnie Brian Caldwell Individual OtherBoard of Directors Jun 1, 2010
Richard Matthews Individual OtherBoard of Directors Jun 1, 2010
Torsten Hirche Individual Corporate OfficerCeo Mar 31, 2014
W-2 Managing EmployeeCeo Mar 31, 2014
Heather James Individual Corporate Director Oct 16, 2009
Presbyterian Retirement Communities Northwest Organization, Seattle, WA 5% Or Greater Direct Ownership Interest Jul 12, 1966 100%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
ParkshoreSeattle, WA, CCN 505493 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257724800000",
    "number": "1306834627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 9TH AVE",
            "address_2": "SUITE 400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042066",
            "telephone_number": "206-826-2120",
            "fax_number": "206-826-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042066",
            "telephone_number": "206-826-2120",
            "fax_number": "206-826-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN RETIREMENT COMMUNITIES NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2009-11-09",
        "status": "A",
        "authorized_official_last_name": "KELLEGREW",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "206-826-2126",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": "BH213",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "NH602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4160206",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skyline at First Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.