Organization Active NPI

Ah, LLC

Doing business as Anderson House

  • Skilled Nursing Facility
  • Shoreline, WA
National Provider Identifier
1508854944
Registry record updated Oct 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH 1328 Issued in WA
Legal business name
AH, LLC
Doing business as
Anderson House
Practice address
17127 15TH Ave NE
Shoreline, WA 98155-5127
Phone
(206) 364-7131
Fax
(206) 361-8262
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2011

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

Authorized official

Name
Mrs. Pamela S. Matiko, RN
Title
Administrator/Member
Phone
(206) 364-7131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH 1328 WA Primary

Addresses

Primary practice location

17127 15TH Ave NE
Shoreline, WA 98155-5127

Mailing address

17127 15TH Ave NE
Shoreline, WA 98155-5127
Phone (206) 364-7131

Other identifiers 1

IdentifierTypeStateIssuer
603094005OtherWAGROUP HEALTH

Other names 1

  • Anderson House Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319760000000",
    "number": "1508854944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17127 15TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981555127",
            "telephone_number": "206-364-7131",
            "fax_number": "206-361-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17127 15TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981555127",
            "telephone_number": "206-364-7131",
            "fax_number": "206-361-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2011-10-28",
        "status": "A",
        "authorized_official_last_name": "MATIKO",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ADMINISTRATOR/MEMBER",
        "authorized_official_telephone_number": "206-364-7131",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "NH 1328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "603094005",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; 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.