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General NPI Number Information
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NPI Number | 1033055272
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Entity Type | Organization
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Legal Business Name | ST. JAMES ADULT FAMILY HOME LLC
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 7620 S AINSWORTH AVE
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City | TACOMA
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State | WA
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Zip | 98408-2009
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Country | US
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Telephone | 206-261-5294
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Fax |
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Provider Business Mailing Address
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Address Line | 35821 1ST PL SW
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City | FEDERAL WAY
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State | WA
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Zip | 98023-7896
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | ATAKHLTI TEFERI
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Credential |
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Telephone | 206-261-5294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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