Northwest Royal Home Care, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

751903 Issued in WA

Legal business name

NORTHWEST ROYAL HOME CARE, LLC

Practice address

7029 NE Fairway Ave
Vancouver, WA 98662-3690

Phone

(360) 524-5653

NPI assigned

Mar 31, 2016

Last updated

Mar 31, 2016By 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

Alla PolyakovNPI 1720424971

Title

Director of Patient Care

Phone

(360) 524-5653

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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.

• Alla Polyakov

  • Registered Nurse
  • Vancouver, WA
  • NPI 1720424971
  NPD (past) Authorized official

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

{
    "created_epoch": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1982067591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7029 NE FAIRWAY AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986623690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7029 NE FAIRWAY AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986623690",
            "telephone_number": "360-524-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ROYAL HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "POLYAKOV",
        "authorized_official_first_name": "ALLA",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT CARE",
        "authorized_official_telephone_number": "360-524-5653"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WA",
            "license": "751903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.