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EVERGREEN OASIS CARE HOME LLC
NPI 1922937697
Custodial Care Facility - Adult Care Home in Lynnwood, WA

Active since May 18, 2026CLIA 50D2329091 · Waiver
4621 180TH ST SW, LYNNWOOD, WA 98037(425) 737-6005 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Evergreen Oasis Care Home Llc NPPES

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

EVERGREEN OASIS CARE HOME LLC (NPI 1922937697) is a healthcare organization registered as an adult care home in Lynnwood, Washington and active in the NPI registry since May 2026. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Aminata Trawally, Provider, as its authorized official.

NPPES Registry Identity

NPI1922937697
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameEVERGREEN OASIS CARE HOME LLC
Location Address4621 180TH ST SWLynnwood, WA 98037-3602
Mailing Address4621 180th St SwLynnwood, WA 98037-3602
Phone(425) 737-6005
Organization SubpartNo
Authorized OfficialAminata TrawallyProvider · (425) 737-6005
Enumeration DateMay 18, 2026
NPPES CertifiedMay 18, 2026
✔ NPI 1922937697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
4621 180TH ST SW, Lynnwood, WA 98037
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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 50D2329091

Evergreen Oasis Care Home · Lynnwood, WA
Active · expires Apr 4, 2028
CLIA Number50D2329091
Laboratory TypeAfh
Certificate Effective DateAugust 21, 2025
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAminata Trawally
Laboratory Phone(425) 309-9524
Laboratory LocationEvergreen Oasis Care Home4621 180th St SW, Lynnwood, WA 98037
CLIA data matches this NPI record on: Address Name
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 Evergreen Oasis Care Home LLC's NPI number?

The NPI number for Evergreen Oasis Care Home LLC is 1922937697. It was assigned to this organization in the NPPES registry on May 18, 2026.

Where is Evergreen Oasis Care Home LLC located?

Evergreen Oasis Care Home LLC is located at 4621 180th St SW, Lynnwood, WA 98037. The listed phone number is (425) 737-6005.

What is Evergreen Oasis Care Home LLC's specialty?

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

Does Evergreen Oasis Care Home LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2329091) 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 Evergreen Oasis Care Home LLC was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.