NPIMap

Organization Active NPI

Lynnwood Health Services, Inc.

Doing business as Lynnwood Post Acute Rehabilitation Center

  • Skilled Nursing Facility
  • Lynnwood, WA
National Provider Identifier
1760439467
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
LYNNWOOD HEALTH SERVICES, INC.
Doing business as
Lynnwood Post Acute Rehabilitation Center
Lynnwood Post Acute and Rehabilitation Center
Practice address
5821 188TH St SW
Lynnwood, WA 98037-4304
Phone
(425) 776-5512
Fax
(425) 776-3230
NPI assigned
May 28, 2006
Last updated
Mar 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Authorized official

Name
Soon Burnam
Title
Treasurer
Phone
(949) 540-1249

Specialties & licenses 1

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

Addresses

Primary practice location

5821 188TH St SW
Lynnwood, WA 98037-4304

Mailing address

5821 188TH St SW
Lynnwood, WA 98037-4304
Phone (425) 776-5512

Other identifiers 1

IdentifierTypeStateIssuer
4113957MedicaidWA

Other names 2

  • Lynnwood Post Acute Rehabilitation Center Doing business as
  • Lynnwood Post Acute and Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060427000213 WA Part A Provider - Skilled Nursing Facility 2567472103 Practice locations: Lynnwood, WA
O20150811003461 WA Part B Supplier - Other 2567472103 Practice locations: Lynnwood, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760439467. Details of each certification follow.

Skilled nursing facility certification: CCN 505434

Legal name
LYNNWOOD HEALTH SERVICES, INC.
Doing business as
LYNNWOOD POST ACUTE REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1992
Last certification
Jul 22, 2024
Beds
67
Ownership / control type
Corporation
Multi-facility organization
Pennant Healthcare, Inc.
Organization structure
CorporationProprietary
Incorporated
Feb 24, 2006 in NV
Enrollment address
5821 188TH St SW
Lynnwood, WA 98037-4304
Nursing home name
LYNNWOOD POST ACUTE REHABILITATION CENTER
Affiliated entity
THE ENSIGN GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lynnwood Post Acute Rehabilitation CenterCCN 505434 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6761.0 residents per day on average
Chain
The Ensign Group342 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
50D0885561Lynnwood Health Services Inc5821 188TH SW, Lynnwood, WA 98037Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Tempay LLC Organization, Kenmore, WA LLC Operational/Managerial Control Jun 1, 2006
Barry Port Individual Corporate OfficerSole Manger Pennant Healthcare LLC Jul 26, 2018
Pennant Healthcare LLC Organization, Mission Viejo, CA LLC, For-profit 5% Or Greater Direct Ownership Interest Aug 21, 2012 100%
The Ensign Group Inc Organization, Mission Viejo, CA 5% Or Greater Indirect Ownership Interest Jul 29, 2002 100%
Ensign Services Inc Organization, Mission Viejo, CA Corporation Operational/Managerial Control Jun 1, 2006
Adp of the SNF Jul 25, 2025
Nathan Holmes Individual Corporate OfficerPresident Lynnwood Health Services, Jan 1, 2023
Managing Control - Governing BodyAuthorized Official Jan 1, 2023
Ami Sato Individual Corporate OfficerTreasurer Lynnwood Health Services, Jun 1, 2006
Tonya Fisher Individual Operational/Managerial ControlAdministrator Jan 1, 2023
Adp of the SNF Jul 5, 2025
Ctr Partnership LP Organization, San Clemente, CA Corporation Adp of the SNF Jun 1, 2006
Caretrust GP LLC Organization, San Clemente, CA Corporation 5% Or Greater Indirect Ownership Interest Jun 1, 2006 100%
Adp of the SNF Jun 1, 2006
Direct Ownership Interest Jun 1, 2006 100%
Lisa Stolarczyk Individual Operational/Managerial Control Mar 21, 2024
Managing Control - Governing BodyMedical Director Mar 21, 2024
Adp of the SNF Jul 5, 2025
Chad Keetch Individual Corporate OfficerSecretary Ensign Services, Inc. Jun 1, 2006
Stephen W Farnsworth Individual Corporate DirectorSole Manager Lynnwood Health Servic Jan 1, 2023
Snohomish Health Holdings LLC Organization, Lynnwood, WA LLC Adp of the SNF Jun 1, 2006
Soon Burnam Individual Corporate OfficerSecretary Lynnwood Health Services, Sep 9, 2024
Managing Control - Governing BodyAuthorized Official Sep 9, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1760439467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5821 188TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374304",
            "telephone_number": "425-776-5512",
            "fax_number": "425-776-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 188TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374304",
            "telephone_number": "425-776-5512",
            "fax_number": "425-776-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNNWOOD HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4113957",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lynnwood Post Acute Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lynnwood Post Acute and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.