KIRKLAND MEMORY CARE, LLC (NPI# 1457995821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457995821 |
| Entity Type | Organization |
| Organization Name | KIRKLAND MEMORY CARE, LLC |
| Practice Address |
12217 Ne 128th St Kirkland WA 98034-7301 |
| Mailing Address |
111 Market St Ne Ste 200 Olympia WA 98501-1008 |
| Practice Telephone | 4252027254 |
| Practice Fax Number | 4253071291 |
| Mailing Telephone | 3608671900 |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-29 |
| Authorized Official Name | EMMETT AARON KOELSCH (PRESIDENT) |
| Authorized Official Telephone | 3608671900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Jefferson House Memory Care Community | Doing Business As Name - Organization |
| Street Address |
12217 NE 128TH ST |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-7301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063976926 | Lakeview of Kirkland | Assisted Living Facility | 6505 Lakeview Dr, Kirkland, WA 98033-6953 | 2019-01-24 |
| 1710021845 | Emeritus Properties X, Inc. | Assisted Living Facility | 6505 Lakeview Dr, Kirkland, WA 98033-6953 | 2007-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215537485 | All Saints Adult Family Home, LLC | Assisted Living Facility | 1413 12th St Ne, Auburn, WA 98002-3533 | 2020-10-27 |
| 1245844497 | Bremerton Mc Operations, LLC | Assisted Living Facility | 3510 9th St, Bremerton, WA 98312-3544 | 2020-09-04 |
| 1104434547 | Sunrise Senior Living Management Inc | Assisted Living Facility | 23599 Se Issaquah Fall City Rd, Issaquah, WA 98029-9265 | 2020-07-22 |
| 1174131999 | Longhouse Bothell LLC | Assisted Living Facility | 16605 122nd Pl Ne, Bothell, WA 98011-7114 | 2020-07-17 |
| 1447878913 | Northwest Hc Columbia Heights Wa Operator Nt-hci LLC | Assisted Living Facility | 1550 Cherry St, Wenatchee, WA 98801-6253 | 2020-07-10 |
| 1881212355 | Northwest Hc Seaport Landing Wa Operator Nt-hci LLC | Assisted Living Facility | 1201 Hancock St, Port Townsend, WA 98368-8513 | 2020-07-10 |
| 1568089472 | Living Court Ventures, L.L.C. | Assisted Living Facility | 2229 Jensen St, Enumclaw, WA 98022-3639 | 2020-06-26 |
| 1154948065 | Sullivan Cottages, L.L.C. | Assisted Living Facility | 411 S Adams Rd, Spokane Valley, WA 99216-2287 | 2020-06-26 |
| 1104443001 | Gig Harbor Ventures, L.L.C. | Assisted Living Facility | 3025 14th Ave Nw, Gig Harbor, WA 98335-1635 | 2020-06-26 |
| 1609493519 | Wenatchee Alf Ventures, L.L.C. | Assisted Living Facility | 601 Okanogan Ave, Wenatchee, WA 98801-6414 | 2020-06-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.