Healthcare Provider Details

I. General information

NPI: 1750224135
Provider Name (Legal Business Name): JEWEL ADULT FAMILY HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2026
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 NW TRUE ST
PULLMAN WA
99163-3347
US

IV. Provider business mailing address

300 NW TRUE ST
PULLMAN WA
99163-3347
US

V. Phone/Fax

Practice location:
  • Phone: 509-715-8326
  • Fax: 509-338-9169
Mailing address:
  • Phone: 509-715-8326
  • Fax: 509-338-9169

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: MR. JOHN MAKAU KIVUVA
Title or Position: OWNER
Credential: PROVIDER
Phone: 509-715-8326