Provider Demographics
NPI:1568682797
Name:THE ASHLEY HOUSE
Entity Type:Organization
Organization Name:THE ASHLEY HOUSE
Other - Org Name:ASHLEY HOUSE NW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-533-9050
Mailing Address - Street 1:33811 9TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6707
Mailing Address - Country:US
Mailing Address - Phone:253-533-9050
Mailing Address - Fax:253-517-7706
Practice Address - Street 1:33811 9TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6707
Practice Address - Country:US
Practice Address - Phone:253-533-9050
Practice Address - Fax:253-517-7706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1022056Medicaid
WA9030560Medicaid