Healthcare Provider Details

I. General information

NPI: 1558219444
Provider Name (Legal Business Name): AMERICAN ADULT FAMILY HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 OLD PIONEER WAY NW
ORTING WA
98360-9516
US

IV. Provider business mailing address

1005 OLD PIONEER WAY NW
ORTING WA
98360-9516
US

V. Phone/Fax

Practice location:
  • Phone: 360-872-1294
  • Fax:
Mailing address:
  • Phone: 360-872-1294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: RAJWINDER SRAN
Title or Position: OWNER
Credential: CNA
Phone: 253-880-8344