Cedar Creek Home, LLC

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

CEDAR CREEK HOME, LLC

Practice address

509 E K St
Deer Park, WA 99006-4012

Phone

(509) 570-8862

NPI assigned

Oct 19, 2026

Last updated

Oct 21, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

CEDAR CREEK HOME, LLCAs reported in NPPES

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

Authorized official

Name

Amy Sue Hansen

Title

Director

Phone

(509) 570-8862

Specialties & licenses 1

Addresses

Other names 1

• Cedar Creek Pathways Other name

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

{
    "created_epoch": "1792368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792540800000",
    "number": "1851297451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 E K ST",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990064012",
            "telephone_number": "509-570-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 E K ST",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990064012",
            "telephone_number": "509-570-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CREEK HOME, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CEDAR CREEK HOME, LLC",
        "enumeration_date": "2026-10-19",
        "last_updated": "2026-10-21",
        "certification_date": "2026-10-21",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "509-570-8862"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Creek Pathways",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joshua Adams Bruns, LPC, LMHC
• Jeffrey N Burnham, ARNP
• Leonard Ray Campbell, RN
• Alayna Grace Cantleberry
• Cher Eleanor Carbett, PHARMD
• Cedar Creek Pathways LLC
• Chattaroy Family Medicine PLLC
• Patricia L Cheyne
• Katherina P Choka, ARNP
• Julie M Christiansen, PMHNP-BC

• Intellectual Disabilities Intermediate Care Facility in Deer Park, WA
• Providers in Deer Park, WA by specialty
• Intellectual Disabilities Intermediate Care Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.