Healthcare Provider Details

I. General information

NPI: 1457277071
Provider Name (Legal Business Name): SENIOR CARE SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 BURGER PL
ENUMCLAW WA
98022-8434
US

IV. Provider business mailing address

PO BOX 1366
ENUMCLAW WA
98022-1366
US

V. Phone/Fax

Practice location:
  • Phone: 360-829-7737
  • Fax: 360-829-7737
Mailing address:
  • Phone: 360-829-7737
  • Fax: 866-611-1634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: TAMI LYNN MOORE
Title or Position: ADMINISTRATOR
Credential: CSA
Phone: 360-829-7737