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PRISTINE HOUSE
NPI 1295357259
Custodial Care Facility - Adult Care Home in Kent, WA

Active since May 13, 2020CLIA 50D2293201 · Waiver
25223 146TH AVE SE, KENT, WA 98042(253) 236-5352(253) 236-8730 Get Directions Write a Review

NPPES record last updated: August 27, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 21, 2024, May 13, 2020 (2 updates tracked since 2020).

About Pristine House NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRISTINE HOUSE (NPI 1295357259) is a healthcare organization registered as an adult care home in Kent, Washington and active in the NPI registry since May 2020. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Anita Khadka, Resident Manager, as its authorized official.

NPPES Registry Identity

NPI1295357259
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NamePRISTINE HOUSE LLC
Location Address25223 146TH AVE SEKent, WA 98042-3410
Mailing Address25223 146th Ave SeKent, WA 98042-3410 · (425) 835-6512 · Fax (253) 236-8730
Phone(253) 236-5352
Fax(253) 236-8730
Organization SubpartNo
Authorized OfficialAnita KhadkaResident Manager · (425) 835-6512
Enumeration DateMay 13, 2020
Last NPPES UpdateAugust 27, 20242 updates tracked since enumeration
NPPES CertifiedAugust 27, 2024
✔ NPI 1295357259 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
Also ListedRegistered NurseTaxonomy 163W00000X
25223 146TH AVE SE, Kent, WA 98042
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Other Names 1

Doing Business AsPristine House

Other Identifiers 1

Medicaid2139440WA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2293201

Pristine House LLC · Kent, WA
Active · expires Apr 4, 2028
CLIA Number50D2293201
Laboratory TypeAfh
Certificate Effective DateNovember 3, 2023
Certificate Expiration DateApril 4, 2028
Laboratory DirectorUjjwal Khadka
Laboratory Phone(253) 236-5352
Laboratory LocationPristine House LLC25223 146th Ave SE, Kent, WA 98042
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pristine House LLC's NPI number?

The NPI number for Pristine House LLC is 1295357259. It was assigned to this organization in the NPPES registry on May 13, 2020. The provider is doing business as Pristine House.

Where is Pristine House LLC located?

Pristine House LLC is located at 25223 146th Ave SE, Kent, WA 98042. The listed phone number is (253) 236-5352.

What is Pristine House LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Does Pristine House LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2293201) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pristine House LLC was last updated on August 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.