NPIMap

Organization Active NPI

Bethany of the Northwest

  • Skilled Nursing Facility
  • Everett, WA
National Provider Identifier
1497884043
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH1049 Issued in WA
Legal business name
BETHANY OF THE NORTHWEST
Doing business as
Bethany at Silver Lake
Practice address
2235 Lake Heights Road
Everett, WA 98201
Phone
(425) 338-3000
Fax
(425) 338-1147
NPI assigned
Mar 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Authorized official

Name
Denney Austin
Title
Ceo
Phone
(425) 551-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH1049 WA Primary

Addresses

Primary practice location

2235 Lake Heights Road
Everett, WA 98201

Mailing address

P.O. Box 5128
Everett, WA 98206-5128
Phone (425) 259-5508

Other identifiers 1

IdentifierTypeStateIssuer
4110490MedicaidWA

Other names 1

  • Bethany at Silver Lake Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100208000724 WA Part A Provider - Skilled Nursing Facility 5597710475 Practice locations: Everett, WA

Skilled nursing facility certification: CCN 505403

Legal name
BETHANY OF THE NORTHWEST
Doing business as
BETHANY AT SILVER LAKE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1992
Last certification
Dec 20, 2024
Beds
151
Ownership / control type
Church Related
Multi-facility organization
Bethany of the Northwest
Organization structure
CorporationNon-profit
Incorporated
Dec 5, 1901 in WA
Enrollment address
2235 Lake Heights Dr
Everett, WA 98208-6030
Nursing home name
BETHANY AT SILVER LAKE

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
Bethany at Silver LakeCCN 505403 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Church related
Certified
Jan 1, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
151115.5 residents per day on average
Penalties (3 years)
2Fines totaling $121,447

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
50D0661475Bethany at Silver Lake2235 Lake Heights Drive, Everett, WA 98208Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Bethany of the Northwest3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Jeff F Gay Individual Corporate DirectorBoard Member Apr 24, 2017 7.14%
Loren J Ihle Individual Corporate Director Jan 23, 2025 7.14%
Susan O Tiu Individual Corporate DirectorBoard Member Jan 3, 2019 7.14%
Mahdiesadat Seyed Aliroteh Individual Corporate Director Apr 4, 2024 7.14%
Steven C Jacobson Individual Corporate DirectorBoard President Jun 27, 2018 7.18%
Navdeep Toor Individual Operational/Managerial Control Oct 1, 2022
Adp of the SNF Oct 1, 2022
Tom Rohde Individual Corporate DirectorBoard Member Jun 7, 2018 7.14%
Bethany of the Northwest Organization, Everett, WA Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Oct 12, 1999 100%
Adp of the SNF Jan 21, 2025
Direct Ownership Interest Oct 12, 1999 100%
Christine Lagerstrom Individual Operational/Managerial Control Feb 25, 2025
Adp of the SNF Feb 25, 2025
Veronica Knudson Individual Corporate Director Jan 23, 2025 7.14%
Lawrence B Stave Individual Corporate Director Jan 23, 2025 7.14%
Tristine C Bauguess Individual Operational/Managerial Control Feb 26, 2025
Adp of the SNF Mar 22, 2017
Joseph R Scrivens Individual Corporate OfficerCeo Dec 6, 2019 100%
Operational/Managerial Control Dec 6, 2019
Adp of the SNF Dec 6, 2019
Robert C Dobler Individual Corporate Director Jan 23, 2025 7.14%
Janice E Nesse Individual Corporate Director Jan 23, 2025 7.14%
Terri K Wallin Individual Corporate DirectorBoard Member Jul 23, 2020 7.14%
Patricia M Degroodt Individual Corporate Director Feb 1, 2023 7.14%
Eric D Nicholson Individual Corporate DirectorTreasurer Oct 26, 2023 7.14%
David R Koenig Individual Corporate DirectorBoard Vice President Mar 1, 2007 7.14%

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Bethany at PacificEverett, WA, CCN 505404 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Oct 12, 1999
Jan 22, 2025
Providence Health Service-WaEverett, WA, CCN 505533 Skilled nursing facility 5% Or Greater Direct Ownership Interest (50%)
Operational/Managerial Control
Adp of the SNF		 Jan 5, 1995
Apr 1, 2020
Feb 27, 2025
Bethany Home Health LLCEverett, WA, CCN 507135 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Mar 22, 2019
Dec 6, 2019
Bethany Hospice LLCEverett, WA, CCN 501564 Hospice 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Feb 2, 2021
Feb 2, 2021

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1497884043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5128",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065128",
            "telephone_number": "425-259-5508",
            "fax_number": "425-258-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 LAKE HEIGHTS ROAD",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98201",
            "telephone_number": "425-338-3000",
            "fax_number": "425-338-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY OF THE NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "DENNEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-551-6400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "NH1049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4110490",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethany at Silver Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.