Healthcare Provider Details

I. General information

NPI: 1396600763
Provider Name (Legal Business Name): GENTLE GUARDIAN ADULT FAMILY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14427 45TH AVE W
LYNNWOOD WA
98087-1854
US

IV. Provider business mailing address

14427 45TH AVE W
LYNNWOOD WA
98087-1854
US

V. Phone/Fax

Practice location:
  • Phone: 206-550-8256
  • Fax: 425-745-6248
Mailing address:
  • Phone: 206-550-8256
  • Fax: 425-745-6248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIMINET M TESFAY M TIMINET M TESFAY
Title or Position: PROVIDER
Credential:
Phone: 206-550-8256