NPIMap

Organization Active NPI

Full Life Care

  • Adult Day Care Clinic/Center
  • Everett, WA
National Provider Identifier
1609120468
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
FULL LIFE CARE
Practice address
2931 Ruker Ave.
Everett, WA 98201
Phone
(425) 355-1313
Fax
(425) 348-3012
NPI assigned
Nov 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Authorized official

Name
Ms. Nora Gibson, MSW
Title
Executive Director
Phone
(206) 467-7033

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ContractorGroup: 193400000X SINGLE SPECIALTY GROUP 171W00000X
Home Health Agency 251E00000X
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

2931 Ruker Ave.
Everett, WA 98201

Mailing address

4712 35TH Ave S
Seattle, WA 98118-1704
Phone (206) 467-7033

Other identifiers 1

IdentifierTypeStateIssuer
501965OtherWADSHS PROVIDER #

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/Da Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Full Life Care3 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.

Locations

2931 Rucker Ave
Everett, WA 98201
Phone (425) 355-1313

4712 35th Ave S
Seattle, WA 98118
Phone (206) 307-6268

NPI Registry JSON

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612828800000",
    "number": "1609120468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 35TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181704",
            "telephone_number": "206-467-7033",
            "fax_number": "206-224-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2931 RUKER AVE.",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98201",
            "telephone_number": "425-355-1313",
            "fax_number": "425-348-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL LIFE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-01",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "NORA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "206-467-7033",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS PROVIDER #",
            "identifier": "501965",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/Da",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4712 35th Ave S",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981181704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; 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.