Shine Life Adult Family Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SHINE LIFE ADULT FAMILY HOME LLC

Practice address

21823 58TH Ave W
Mountlake Terrace, WA 98043-3129

Phone

(425) 774-7073

Fax

(425) 775-1070

NPI assigned

Oct 6, 2026

Last updated

Oct 6, 2026By 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

Mr. Daniel Mamo Abebe

Title

Administrator

Phone

(206) 859-0065

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1791244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791244800000",
    "number": "1437053097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21823 58TH AVE W",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980433129",
            "telephone_number": "425-774-7073",
            "fax_number": "425-775-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21823 58TH AVE W",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980433129",
            "telephone_number": "425-774-7073",
            "fax_number": "425-775-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINE LIFE ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-06",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A",
        "authorized_official_last_name": "ABEBE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "MAMO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "206-859-0065",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Lee Shafer
• Crystal Sharpe
• Cynthia G Shaw, LICSW
• Kyenaat Naz Sheikh
• Mark S Shelley, DC
• Kyle Shorack
• Christine Ann Sicuro-Fouty, OTR/L
• Funmilola Omolola Sijuade, PMHNP-BC
• Mark Alan Silver, MD
• Emily Simmonds, DPT

• Adult Care Home Facility in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; 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.