Park Shore – Assisted Living Facility, NPI 1801887641

Park Shore is a healthcare provider. based in Seattle, Washington. specializing in Assisted Living Facility. The organization holds a License No. 489 (WA). The NPI Number for Park Shore is 1801887641

Main info

Organization
Name
Park Shore
NPI
1801887641
Phone
(206) 329-0770
Address
1630 43RD AVE E
Authorized Official
MS. JANET E NAHLIN DIRECTOR OF NURSING SERVICES RN
Enumeration Date
1 November 2005
Last Update Date
11 September 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness90
Years active:20State licenses:2Digital endpoints

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Provider Addresses for Park Shore

  • Park Shore, 1630, 43rd Avenue East, Madison Park, Seattle, King County, Washington, 98112, United States

    SEATTLE, WA 981126210

    Phone: (206) 329-0770

    Fax: (206) 329-0227

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-08-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20100802000388OSkilled Nursing FacilityWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98112)

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Reviews

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Frequently asked questions

Does Park Shore share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Park Shore uses 1801887641.
Can I rely on Park Shore being an active provider?
As of the registry snapshot, Park Shore is marked active.
What taxonomy line describes Park Shore?
For research purposes, treat Park Shore as Assisted Living Facility in this dataset. Clinical services aligned with this taxonomy classification.
Does Park Shore list a practice location?
Patients near Seattle, Washington may find Park Shore in results; validate coverage separately.
Is the information about Park Shore up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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