Organization Active NPI

Avalon Care Center - Federal Way LLC

  • Skilled Nursing Facility
  • Federal Way, WA
National Provider Identifier
1902890262
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1355 Issued in WA
Legal business name
AVALON CARE CENTER - FEDERAL WAY LLC
Practice address
135 S 336TH St
Federal Way, WA 98003-6350
Phone
(253) 835-7453
Fax
(253) 835-3903
NPI assigned
Sep 1, 2005
Last updated
Mar 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Charles Kirton
Title
Ceo/Chairman
Phone
(801) 596-8844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1355 WA Primary

Addresses

Primary practice location

135 S 336TH St
Federal Way, WA 98003-6350

Mailing address

206 N 2100 W
Salt Lake City, UT 84116-2927
Phone (801) 325-0153

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030920000011 WA Part A Provider - Skilled Nursing Facility 7315858495 Practice locations: Federal Way, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902890262. Details of each certification follow.

Skilled nursing facility certification: CCN 505510

Legal name
AVALON CARE CENTER - FEDERAL WAY, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Aug 2, 2002
Last certification
Jul 24, 2024
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Avalon
Organization structure
LLCProprietary
Incorporated
Aug 26, 2003 in WA
Enrollment address
135 S 336TH St
Federal Way, WA 98003-6350
Nursing home name
AVALON CARE CENTER FEDERAL WAY, L.L.C.
Affiliated entity
AVALON HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avalon Care Center Federal Way, L.L.C.CCN 505510 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Aug 2, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120109.5 residents per day on average
Chain
Avalon Health Care16 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
50D0995915Avalon Care Center Federal Way135 S 336TH St, Federal Way, WA 98003Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Atique Ahmad Individual Operational/Managerial Control Mar 26, 2025
Adp of the SNF Mar 26, 2025
The Byron a Kirton Individual TR Organization, Alpine, UT 5% Or Greater Indirect Ownership Interest Oct 1, 2025 26.67%
Robert D Woltil Individual Corporate DirectorBoard Director May 23, 2012
Managing Control - Governing BodyBoard Director May 23, 2012
Organization, Los Angeles, CA LLC, For-profit Adp of the SNF Nov 30, 2004
Avalon Health Care Management Inc Organization, Salt Lake City, UT Corporation, Management services company, For-profit Operational/Managerial Control Dec 1, 2003
Adp of the SNF Apr 9, 2025
Samantha Wachowski Individual Operational/Managerial Control Dec 29, 2022
Adp of the SNF Dec 29, 2022
Hyrum a Kirton Individual TR Organization, Sandy, UT 5% Or Greater Indirect Ownership Interest Oct 1, 2025 33.33%
Spencer Kirton Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2025 33.33%
Corporate DirectorBoard Director Aug 27, 2024
Managing Control - Governing BodyBoard Director Aug 27, 2024
Nicole Smith Individual Corporate OfficerChief Nursing Officer Mar 1, 2023
Operational/Managerial Control Mar 1, 2023
Adp of the SNF Mar 1, 2023
Avalon Health Care Inc Organization, Salt Lake City, UT Corporation, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2003 100%
Operational/Managerial Control Dec 1, 2003
Adp of the SNF May 14, 2025
Byron a Kirton Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2025 33.33%
Corporate DirectorBoard Director Aug 27, 2024
Managing Control - Governing BodyBoard Director Aug 27, 2024
Avalon of Washington LLC Organization, Salt Lake City, UT LLC, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 20, 2004 100%
Inga Stoa Individual Operational/Managerial Control Sep 10, 2025
Adp of the SNF Sep 10, 2025
K-Team LLC Organization, Alpine, UT LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2025 6.67%
Avalon Care LLC Organization, Salt Lake City, UT LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 1, 2004 100%
Hyrum Kirton Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2025 33.33%
Corporate OfficerSenior Vice President Mar 29, 2022
Corporate DirectorBoard Director Aug 27, 2024
Operational/Managerial Control Mar 29, 2022
Managing Control - Governing BodyBoard Director Aug 27, 2024
Adp of the SNF Mar 29, 2022
Spencer K Kirton Individual TR Organization, Coalville, UT 5% Or Greater Indirect Ownership Interest Oct 1, 2025 33.33%
Maria Borisevich Individual Corporate OfficerChief Financial Officer Jan 8, 2024
Operational/Managerial Control Jan 8, 2024
Adp of the SNF Jan 8, 2024
David E Dangerfield Individual Corporate DirectorBoard Director Apr 5, 2007
Managing Control - Governing BodyBoard Director Apr 5, 2007
Avalon Holding Inc Organization, Salt Lake City, UT Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 1, 2003 100%
Alan B Hash Individual Corporate OfficerCeo Aug 15, 2017
Operational/Managerial Control Aug 15, 2017
Adp of the SNF Aug 15, 2017

Owners & managing parties with NPI records 1

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

Facilities with the same owner 17

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

View all 17

Practitioners & affiliated clinicians

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.

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": "1125532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1902890262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N 2100 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841162927",
            "telephone_number": "801-325-0153",
            "fax_number": "801-596-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S 336TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036350",
            "telephone_number": "253-835-7453",
            "fax_number": "253-835-3903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON CARE CENTER - FEDERAL WAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-01",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "KIRTON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO/CHAIRMAN",
        "authorized_official_telephone_number": "801-596-8844"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.