Healthcare Provider Details

I. General information

NPI: 1376486308
Provider Name (Legal Business Name): KRKY DEVELOPMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 GOLF DR
MALAGA WA
98828-9795
US

IV. Provider business mailing address

2490 GOLF DR
MALAGA WA
98828-9795
US

V. Phone/Fax

Practice location:
  • Phone: 509-888-2736
  • Fax: 509-888-4863
Mailing address:
  • Phone: 509-888-2736
  • Fax: 509-888-4863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: REBECCA LENSSEN
Title or Position: OWNER
Credential:
Phone: 509-679-0099