Active NPI
Mountlake Terrace Afh 1 LLC
- Assisted Living Facility
- Mountlake Terrace, WA
National Provider Identifier
1497646939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- MOUNTLAKE TERRACE AFH 1 LLC
- Practice address
- 23108 54TH Ave W
Mountlake Terrace, WA 98043-4708 - Phone
- (425) 670-2867
- NPI assigned
- Jul 12, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tsehay Ghebresilassie
- Title
- Provider
- Phone
- (206) 330-3293
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
23108 54TH Ave W
Mountlake Terrace, WA 98043-4708
Mailing address
8907 192ND St SW
Edmonds, WA 98026-6129
Phone (206) 330-3293
Other practice location 1
23108 54th Ave W
Mountlake Terrace, WA 98043-4708
Phone (425) 670-2867
Other names 1
- Mountlake Terrace AFH LLC
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752278400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1752278400000",
"number": "1497646939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8907 192ND ST SW",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980266129",
"telephone_number": "206-330-3293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23108 54TH AVE W",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980434708",
"telephone_number": "425-670-2867"
}
],
"practiceLocations": [
{
"address_1": "23108 54th Ave W",
"address_purpose": "LOCATION",
"city": "Mountlake Terrace",
"state": "WA",
"postal_code": "980434708",
"country_code": "US",
"telephone_number": "425-670-2867",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "MOUNTLAKE TERRACE AFH 1 LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-07-12",
"last_updated": "2025-07-12",
"certification_date": "2025-07-12",
"status": "A",
"authorized_official_last_name": "GHEBRESILASSIE",
"authorized_official_first_name": "TSEHAY",
"authorized_official_title_or_position": "PROVIDER",
"authorized_official_telephone_number": "206-330-3293"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Mountlake Terrace AFH LLC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Mountlake Terrace, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.