Serenity Woods , LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SERENITY WOODS , LLC

Practice address

14413 Salal Dr
Edmonds, WA 98026-3654

Phone

(425) 741-1224

Fax

(425) 741-1243

NPI assigned

Mar 25, 2024

Organization subpart

No

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

Authorized official

Name

Ian Wallace, NAR

Title

Member

Phone

(206) 778-9199

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1679323323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 MAIN ST # 308",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336108",
            "telephone_number": "206-778-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14413 SALAL DR",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980263654",
            "telephone_number": "425-741-1224",
            "fax_number": "425-741-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY WOODS , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "206-778-9199",
        "authorized_official_credential": "NAR"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Selmann, LMP
• Mireille P Sema, LMP
• Nizar H. Senussi, MD
• Ha-Neul Seo, MD
• Mara Serafin X, LMHC
• Denise M Serfas, MSW, LICSW
• Sonja J. Serwold, PT
• Samuel K Seto, M.D.
• Steven Jiansuen Seto
• Katherine A. Severinghaus, DPT

• Adult Care Home Facility in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.