Healthcare Provider Details
I. General information
NPI: 1821917147
Provider Name (Legal Business Name): 1ST CHOICE ADULT CARE HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
618 116TH ST SE
EVERETT WA
98208-5552
US
IV. Provider business mailing address
618 116TH ST SE
EVERETT WA
98208-5552
US
V. Phone/Fax
- Phone: 425-737-5405
- Fax: 425-663-4050
- Phone: 425-737-5405
- Fax: 425-663-4050
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 311ZA0620X |
| Taxonomy | Adult Care Home Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FATOUMATA
TRAWALLY
Title or Position: PROVIDER/OWNER
Credential:
Phone: 425-737-5405