NPIMap

Organization Active NPI

Salt Creek Beach, LLC

  • Skilled Nursing Facility
  • Edmonds, WA
National Provider Identifier
1548061609
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SALT CREEK BEACH, LLC
Practice address
21400 72ND Ave W
Edmonds, WA 98026-7702
Phone
(425) 775-1961
NPI assigned
Mar 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Ryan Williams
Title
Manager
Phone
(916) 945-1248

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

21400 72ND Ave W
Edmonds, WA 98026-7702

Mailing address

599 Menlo Dr Ste 200
Rocklin, CA 95765-3725

Other names 1

  • Edmonds Post Acute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250602000245 WA Part A Provider - Skilled Nursing Facility 0840709960 Practice locations: Edmonds, WA

Skilled nursing facility certification: CCN 505236

Legal name
SALT CREEK BEACH, LLC
Doing business as
EDMONDS POST ACUTE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 1, 1977
Last certification
Nov 26, 2024
Beds
128
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Kalesta Healthcare Group
Organization structure
LLCProprietary
Enrollment address
21400 72ND Ave W
Edmonds, WA 98026-7702
Nursing home name
EDMONDS POST ACUTE
Affiliated entity
KALESTA HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Edmonds Post AcuteCCN 505236
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Aug 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
128115.2 residents per day on average
Chain
Kalesta Healthcare Group19 facilities in the chain

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
50D0629953Edmonds Post Acute21400 72ND Ave W, Edmonds, WA 98026Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Scott Clawson Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2025 44.05%
Operational/Managerial Control Jun 1, 2025
Micah Porter Individual Indirect Ownership Interest Jun 1, 2025 7%
Scott Clawson Individual Operational/Managerial Control Jun 1, 2025
Indirect Ownership Interest Jun 1, 2025 44.05%
Ryan Williams Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2025 44.05%
Operational/Managerial Control Jun 1, 2025
Alarik Fryling Individual Operational/Managerial Control Jun 1, 2025
Adp of the SNF Jun 1, 2025
Kalesta Healthcare Group, LLC Organization, Rocklin, CA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 1, 2025
Brandon Reedy-Matrone Individual Operational/Managerial Control Jun 1, 2025
Adp of the SNF Jun 1, 2025

Facilities with the same owner 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 4

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

Affiliated clinicians 1

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": "1742774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1548061609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 MENLO DR STE 200",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957653725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21400 72ND AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267702",
            "telephone_number": "425-775-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT CREEK BEACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "916-945-1248"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edmonds Post Acute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.