Active NPI
Maria Magdalena Mauricio Serafin
- Adult Care Home Facility
- Marysville, WA
National Provider Identifier
1780356550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- 755164
- Practice address
- 4310 92ND St NE
Marysville, WA 98270-2539 - Phone
- (360) 925-6390
- Fax
- (360) 925-6390
- NPI assigned
- Sep 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | 755164 | WA | Primary |
Addresses
Primary practice location
4310 92ND St NE
Marysville, WA 98270-2539
Mailing address
4310 92ND St NE
Marysville, WA 98270-2539
Phone (360) 925-6390
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 755164 | WA | MD | Adult Care Home Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632960000000",
"number": "1780356550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4310 92ND ST NE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982702539",
"telephone_number": "360-925-6390",
"fax_number": "360-925-6390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4310 92ND ST NE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982702539",
"telephone_number": "360-925-6390",
"fax_number": "360-925-6390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERAFIN",
"first_name": "MARIA MAGDALENA",
"middle_name": "MAURICIO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-30",
"last_updated": "2021-09-30",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "WA",
"license": "755164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
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- Selevive Continuum of Care Afh
- Senior Doc Wa PC
- Serenity Minds Health PLLC
- Rebecca Lynn Sewares, LMP
- Tiffany Lee Shanks, LMP
- Sydney Shaphren, MCOUN, NCC
- Hannah Dereen Sharpe, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.