Pinecone Heights Corporation

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

752487 Issued in WA

Legal business name

PINECONE HEIGHTS CORPORATION

Practice address

1171 Camas Ave NE
Renton, WA 98056-2918

Phone

(206) 940-1020

Fax

(425) 523-3990

NPI assigned

Oct 9, 2013

Organization subpart

No

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

Authorized official

Name

Susan J Holliday

Title

President

Phone

(206) 940-1020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Crest Manor AFH Doing business as

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1770910663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10541 SE 226TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980312621",
            "telephone_number": "206-940-1020",
            "fax_number": "425-523-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 CAMAS AVE NE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980562918",
            "telephone_number": "206-940-1020",
            "fax_number": "425-523-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECONE HEIGHTS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "HOLLIDAY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-940-1020"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WA",
            "license": "752487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIENT SERVICE CONTRACT",
            "identifier": "320914",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crest Manor AFH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dorothy Suzanne Pianko, FNP
• Tera A Pickard, PT
• Tatyana Mikhailovna Pidgorodetskaya, LMT
• Emily Louise Pieper, LMHC, SUDP, MHP
• Jessica Ann Pierce
• Dinelle Maria Pineda, MD
• Brent James Pinedo, MD
• Samantha Pinedo, DO
• Sandra Lynne Pitchford, PHARMACY TECHNICIAN
• Rachel A Pittenger, CPM

• Adult Care Home Facility in Renton, WA
• Providers in Renton, 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 Oct 9, 2013; 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.