Organization Active NPI

Eastside Retirement Association

  • Skilled Nursing Facility
  • Redmond, WA
National Provider Identifier
1861597205
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
EASTSIDE RETIREMENT ASSOCIATION
Practice address
10901 176TH Circle NE
Redmond, WA 98052-7218
Phone
(425) 556-8100
Fax
(425) 556-8104
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Authorized official

Name
Lisa A. Hardy
Title
President and Ceo
Phone
(425) 556-8100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1113 WA
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

10901 176TH Circle NE
Redmond, WA 98052-7218

Mailing address

10901 176TH Circle NE
Redmond, WA 98052-7218
Phone (425) 556-8100

Other identifiers 1

IdentifierTypeStateIssuer
41-111-34MedicaidWA

Other names 1

  • Corwin Center at Emerald Heights Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111109000178 WA Part A Provider - Skilled Nursing Facility 8022175983 Practice locations: Redmond, WA

Skilled nursing facility certification: CCN 505478

Legal name
EASTSIDE RETIREMENT ASSOCIATION
Doing business as
CORWIN CENTER AT EMERALD HEIGHTS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 8, 1992
Last certification
Apr 23, 2025
Beds
61
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Emerald Communities
Organization structure
CorporationNon-profit
Enrollment address
10901 176TH Cir NE
Redmond, WA 98052-7218
Nursing home name
CORWIN CENTER AT EMERALD HEIGHTS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Corwin Center At Emerald HeightsCCN 505478
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Dec 8, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6149.8 residents per day on average
Penalties (3 years)
1Fines totaling $39,468

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0866827Emerald Heights10901 176TH Circle, NE, Redmond, WA 98052Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jamilyn Bloodworth Individual Operational/Managerial Control Nov 1, 2023
Adp of the SNF Nov 1, 2023
Masoud S Taleghani Individual Operational/Managerial Control Oct 1, 2024
Adp of the SNF Oct 1, 2024
Corey Weisner Individual Corporate DirectorCorporate Controller Oct 14, 2024
Adp of the SNF Oct 14, 2024
Craig Comfort Individual Corporate Director Jan 4, 2016
Adp of the SNF Jan 4, 2016
Michelle Wood Individual Corporate OfficerVP Operations Apr 17, 2023
Adp of the SNF Apr 17, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1861597205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10901 176TH CIRCLE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980527218",
            "telephone_number": "425-556-8100",
            "fax_number": "425-556-8104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10901 176TH CIRCLE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980527218",
            "telephone_number": "425-556-8100",
            "fax_number": "425-556-8104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE RETIREMENT ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "425-556-8100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1113",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41-111-34",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corwin Center at Emerald Heights",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.