Angel Haven by the Creek LLC

Primary specialty

Registered NurseTaxonomy code 163W00000X

Legal business name

ANGEL HAVEN BY THE CREEK LLC

Doing business as

Angel Haven 4

Practice address

813 26TH St SE
Auburn, WA 98002-7706

Phone

(253) 279-7919

Fax

(253) 737-4437

NPI assigned

Jan 8, 2025

Last updated

Jan 8, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gordon Herrick II, RNNPI 1285094698

Title

Afh Provider

Phone

(253) 279-7919

Specialties & licenses 1

Addresses

Other names 1

• Angel Haven 4 Doing business as

Practitioners 1

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.

• Gordon A Herrick II, RN

  • Registered Nurse
  • Auburn, WA
  • NPI 1285094698
  NPD Authorized official

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1841000346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20706 61ST ST E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916137",
            "telephone_number": "253-279-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 26TH ST SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980027706",
            "telephone_number": "253-279-7919",
            "fax_number": "253-737-4437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL HAVEN BY THE CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "HERRICK",
        "authorized_official_first_name": "GORDON",
        "authorized_official_title_or_position": "AFH PROVIDER",
        "authorized_official_telephone_number": "253-279-7919",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angel Haven 4",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyllie Anderson
• Nathaniel Joseph Anderson
• Rosemary Anderson, CDP
• Stephen H. Anderson, MD
• Whitney Nicole Andrews, LSWAIC
• Angela Attri, LLC
• Angelica Nurse Delegators
• Darlene M Angeline
• Marylou Parame Aninion, NAC
• Neville Antia, M.P,H., M.D.

• Registered Nurse in Auburn, WA
• Providers in Auburn, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.