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General NPI Number Information
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NPI Number | 1356224836
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Entity Type | Organization
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Legal Business Name | PURE ADULT FAMILY HOME LLC
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 2912 SW 333RD ST
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City | FEDERAL WAY
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State | WA
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Zip | 98023-2727
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Country | US
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Telephone | 253-293-6245
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Fax | 253-392-2427
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Provider Business Mailing Address
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Address Line | 4220 S 246TH CT
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City | KENT
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State | WA
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Zip | 98032-4155
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Country | US
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Telephone | 206-931-3163
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Fax | 253-392-2427
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Authorized Official
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Title or Position | PARTNER
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Name | ESAYAS MEZGEBU
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Credential |
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Telephone | 206-931-3163
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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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