Healthcare Provider Details

I. General information

NPI: 1306183710
Provider Name (Legal Business Name): LIFELONG HEALTH FOR ALL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4634 E MARGINAL WAY S STE C200
SEATTLE WA
98134-2386
US

IV. Provider business mailing address

4634 E MARGINAL WAY S STE C200
SEATTLE WA
98134-2386
US

V. Phone/Fax

Practice location:
  • Phone: 206-957-1670
  • Fax:
Mailing address:
  • Phone: 206-957-1670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAMES SHACKELFORD
Title or Position: CEO
Credential:
Phone: 206-600-1186