North Creek Retirement & Assisted Living Community LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

NORTH CREEK RETIREMENT & ASSISTED LIVING COMMUNITY LLC

Practice address

1907 201St Place SE
Bothell, WA 98012

Phone

(425) 483-8927

Fax

(425) 488-5651

NPI assigned

Dec 18, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kelley D Hamilton

Title

Ceo/President of Management Company

Phone

(503) 373-3125

Specialties & licenses 1

Addresses

Other names 1

• North Creek Retirement & Assisted Living Community 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

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1831373554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 STATE ST",
            "address_2": "SUITE 200",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973016872",
            "telephone_number": "503-373-3125",
            "fax_number": "503-588-3531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 201ST PLACE SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "98012",
            "telephone_number": "425-483-8927",
            "fax_number": "425-488-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CREEK RETIREMENT & ASSISTED LIVING COMMUNITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO/PRESIDENT OF MANAGEMENT COMPANY",
        "authorized_official_telephone_number": "503-373-3125",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Creek Retirement & Assisted Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Point of Service in Bothell, WA
• Providers in Bothell, WA by specialty
• Point of Service in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.