Healthcare Provider Details

I. General information

NPI: 1851203483
Provider Name (Legal Business Name): PUYALLUP LOVING ARMS AFH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10024 140TH STREET CT E
PUYALLUP WA
98373-2567
US

IV. Provider business mailing address

10024 140TH STREET CT E
PUYALLUP WA
98373-2567
US

V. Phone/Fax

Practice location:
  • Phone: 253-697-6465
  • Fax: 253-733-1221
Mailing address:
  • Phone: 253-697-6465
  • Fax: 253-733-1221

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: MESFIN BERHE GEBREYOWHANNES
Title or Position: OWNER
Credential:
Phone: 206-458-3586