Organization Active NPI

Mountlake Terrace Afh 1 LLC

  • Assisted Living Facility
  • Mountlake Terrace, WA
National Provider Identifier
1497646939
Registry record updated Jul 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
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

Updated by the provider on Jul 12, 2025

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)CodeLicenseStatePrimary
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 Former legal business name

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.