MOUNTLAKE TERRACE AFH 1 LLC
NPI 1497646939
Assisted Living Facility in Mountlake Terrace, WA

NPI Status: Active since July 12, 2025

Contact Information

23108 54TH AVE W
MOUNTLAKE TERRACE, WA
ZIP 98043
Phone: (425) 670-2867

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 50D2342686
  • CLIA Cert. Type: Other - AFH
  • CLIA Exp. Date: 04-04-2028

About MOUNTLAKE TERRACE AFH 1 LLC

This page provides the complete NPI Profile along with additional information for Mountlake Terrace Afh 1 Llc, a provider established in Mountlake Terrace, Washington operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1497646939 assigned on July 2025. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Tsehay Ghebresilassie (Provider)

NPI
1497646939
Provider Name
MOUNTLAKE TERRACE AFH 1 LLC
Entity Type
Organization
Location Address
23108 54TH AVE W MOUNTLAKE TERRACE, WA 98043
Location Phone
(425) 670-2867
Mailing Address
8907 192ND ST SW EDMONDS, WA 98026
Mailing Phone
(206) 330-3293
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-12-2025
Last Update Date
07-12-2025
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Location Map

Secondary Locations

  • 23108 54th Ave W
    Mountlake Terrace, WA 98043
    (425) 670-2867

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TSEHAY GHEBRESILASSIE

Authorized Official Title
PROVIDER
Authorized Official Phone
(206) 330-3293

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
50D2342686
Facility Type
Other - AFH
Certificate Effective Date
April 23, 2026
Certificate Expiration Date
April 04, 2028
Laboratory Director
TSEHAY GHEBRESILASSIE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Mountlake Terrace Afh 1 Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1497646939, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
7
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
4
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
9
Unchanged
Pos 9
3
Doubled → 6
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 6 → 12 → 3 6 → 12 → 3 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 8 + 7 + 1 + 2 + 4 + 1 + 2 + 9 + 6 + 24 = 71

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 71 is 80. The difference is the calculated check digit.

80 - 71 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1497646939.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1497646939, enumerated as an "organization" on July 12, 2025.

The provider is located at 23108 54TH AVE W MOUNTLAKE TERRACE, WA 98043 and the phone number is (425) 670-2867.

Assisted Living Facility with taxonomy code 310400000X.