=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043151970
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APPLETREE ADULT FAMILY HOME
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2026
-----------------------------------------------------
Last Update Date | 04/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 SW 4TH AVE
-----------------------------------------------------
City | BATTLE GROUND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98604-8403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-968-2054
-----------------------------------------------------
Fax | 360-342-8954
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 205 SW 4TH AVE
-----------------------------------------------------
City | BATTLE GROUND
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98604-8403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-968-2054
-----------------------------------------------------
Fax | 360-342-8954
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | PAULINE WANGARI MWATHI
-----------------------------------------------------
Credential | LPN
-----------------------------------------------------
Telephone | 916-968-2054
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311ZA0620X
-----------------------------------------------------
Taxonomy Name | Adult Care Home Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------