Cordial Palace B Afh LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

CORDIAL PALACE B AFH LLC

Practice address

9105 78TH St SW
Lakewood, WA 98498-3903

Phone

(253) 226-4800

NPI assigned

Jun 25, 2024

Organization subpart

No

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

Authorized official

Name

Purity WakabaNPI 1750862009

Title

Owner

Phone

(253) 226-4800

Specialties & licenses 1

Addresses

Other names 1

• CORDIAL PALACE B AFH LLC Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Cordial Palace Afh LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cordial Palace Afh LLC

  • Adult Care Home Facility
  • University Place, WA
  • NPI 1396589578
  NPD tax ID

Practitioners 1

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

• Purity Wakaba, RN

  • Registered Nurse
  • University Place, WA
  • NPI 1750862009
  NPD Authorized official

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1700620531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9105 78TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984983903",
            "telephone_number": "253-226-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9105 78TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984983903",
            "telephone_number": "253-226-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDIAL PALACE B AFH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "WAKABA",
        "authorized_official_first_name": "PURITY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-226-4800"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORDIAL PALACE B AFH LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Coolbaugh, NURSE PRACTITIONER
• Allan C Cooney
• Megan Patricia Bustrillo Copple
• Spencer A Coray, MD
• Kathy Ann Corbin, M.A., L.M.H.C.
• Kelsey Elizabeth Corley, LMHC
• Christina Cornelio
• Sarah Mae Cornell-Maier
• Cornerstone Family Physicians
• Morgan Cornett

• Adult Care Home Facility in Lakewood, WA
• Providers in Lakewood, 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 Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.