NPIMap

Organization Active NPI

Humangood Washington

  • Skilled Nursing Facility
  • Des Moines, WA
National Provider Identifier
1891876306
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
797 Issued in WA
Legal business name
HUMANGOOD WASHINGTON
Practice address
23600 Marine View Dr S
Des Moines, WA 98198
Phone
(206) 824-4000
Fax
(206) 878-6404
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Authorized official

Name
Gwen Ellen Vangelisto
Title
Director of Accounts Receivable
Phone
(949) 463-0893

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 797 WA Primary

Addresses

Primary practice location

23600 Marine View Dr S
Des Moines, WA 98198

Mailing address

1900 Huntington Dr
Duarte, CA 91010-2694
Phone (818) 247-0420

Other identifiers 1

IdentifierTypeStateIssuer
4179701MedicaidWA

Other names 1

  • Judson Park Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120111000822 WA Part A Provider - Skilled Nursing Facility 8527235779 Practice locations: Des Moines, WA

Skilled nursing facility certification: CCN 505455

Legal name
HUMANGOOD WASHINGTON
Doing business as
JUDSON PARK HEALTH CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1992
Last certification
May 9, 2024
Beds
96
Ownership / control type
Nonprofit Corporation
Multi-facility organization
HumanGood
Organization structure
CorporationNon-profit
Enrollment address
23620 Marine View Dr S
Des Moines, WA 98198-7352
Nursing home name
JUDSON PARK HEALTH CENTER
Affiliated entity
HUMANGOOD

Care Compare: Nursing home

Medicare Care Compare
Listed as
Judson Park Health CenterCCN 505455
Overall star rating
5 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 1, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9683.8 residents per day on average
Chain
Humangood17 facilities in the chain

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
50D0661469Judson Park Health Center23620 Marine View Dr S, Des Moines, WA 98198Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6120 Stoneridge Mall Rd
Ste 300
Pleasanton, CA 94588

Ownership & related parties

All disclosed owners & managing parties 28

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

NameRoleSinceShare
Individual Adp of the SNF Nov 1, 2022
Bret a Tinker Individual Corporate DirectorBoard Member May 1, 2016
Operational/Managerial Control May 1, 2016
Bradley J Schmitz Individual Operational/Managerial Control May 1, 2020
Adp of the SNF May 1, 2020
Jessica Lopez Individual Operational/Managerial Control Jan 20, 2020
Jonathan T Boyar Individual Operational/Managerial Control Jun 1, 2021
Adp of the SNF Jun 1, 2021
Baker Tilly US LLP Organization, Madison, WI Adp of the SNF Oct 15, 2024
Albert W Kelley Individual Corporate DirectorBoard Member May 1, 2016
Operational/Managerial Control May 1, 2016
Washington Federal Organization, Seattle, WA Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Apr 1, 2018 100%
Adp of the SNF May 16, 2012
John H. Cochrane Individual Corporate OfficerCeo/President May 1, 2016
Operational/Managerial Control May 1, 2016
Humangood Norcal Organization, Duarte, CA Corporation, Non-profit Operational/Managerial Control May 16, 2012
Adp of the SNF May 16, 2012
Judith D Baker Individual Corporate DirectorBoard Member May 1, 2016
Operational/Managerial Control May 1, 2016
David Dahan Individual Corporate DirectorBoard Member May 1, 2016
Operational/Managerial Control May 1, 2016
Herman Declan Brown Individual Corporate OfficerSecretary/Board Member May 1, 2016
Corporate DirectorBoard Member/Secretary May 1, 2016
Operational/Managerial Control May 1, 2016
Bethany J Ghassemi Individual Corporate OfficerClo/Secretary May 21, 2019
Operational/Managerial Control May 28, 2019
Gwen Vangelisto Individual Operational/Managerial Control Aug 30, 2021
Adp of the SNF Aug 30, 2021
Baker Tilly Advisory Group LP Organization, Madison, WI Adp of the SNF Mar 21, 2025
Daniel Ogus Individual Corporate OfficerCoo/VP Executive Aug 27, 2009
Operational/Managerial Control May 1, 2016
Andrew McDonald Individual Corporate OfficerChief Financial Officer Jan 1, 2020
Operational/Managerial Control Jan 1, 2020
U.S. Bank Organization, San Francisco, CA Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Apr 1, 2018 41%
Adp of the SNF Apr 2, 2018
Humangood Organization, Duarte, CA Corporation, Consulting firm, Non-profit 5% Or Greater Indirect Ownership Interest May 1, 2016 100%
Adp of the SNF May 1, 2016
Humangood Washington Organization, Duarte, CA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 14, 1994 100%
Operational/Managerial Control Jan 1, 1992
Adp of the SNF Jan 1, 1992
Organization, Portland, OR LLC Adp of the SNF Mar 27, 2017
Andrea Pratten Individual Operational/Managerial Control Oct 30, 2023
Adp of the SNF Oct 30, 2023
David R Decker Individual Corporate DirectorBoard Member May 1, 2016
Operational/Managerial Control May 1, 2016
Robert M Williams Individual Corporate DirectorBoard Member Mar 13, 2024
Operational/Managerial Control Mar 13, 2024
Humangood Cornerstone Organization, Duarte, CA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2016 100%
Adp of the SNF May 1, 2016
Rand M Ferris Individual Corporate DirectorBoard Member Feb 25, 2017
Operational/Managerial Control May 1, 2016
Jennifer Kennedy Individual Operational/Managerial Control Dec 7, 2023
Adp of the SNF Dec 7, 2023

Owners & managing parties with NPI records 7

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

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 16

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 1

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": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748822400000",
    "number": "1891876306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HUNTINGTON DR",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910102694",
            "telephone_number": "818-247-0420",
            "fax_number": "949-528-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23600 MARINE VIEW DR S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "98198",
            "telephone_number": "206-824-4000",
            "fax_number": "206-878-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMANGOOD WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A",
        "authorized_official_last_name": "VANGELISTO",
        "authorized_official_first_name": "GWEN",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "DIRECTOR OF ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "949-463-0893"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4179701",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Judson Park Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Judson Park Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, WA

Sources for this page

Verify at the official NPI Registry.