# PRISTINE HOUSE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pristine House
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295357259
- **Authorized official:** MRS. ANITA KHADKA RN (RESIDENT MANAGER)
- **Authorized official phone:** (425) 835-6512

## Contact information

- **Practice address:** 25223 146TH AVE SE, KENT, WA 98042-3410
- **Practice address phone:** (253) 236-5352
- **Practice address fax:** (253) 236-8730
- **Mailing address:** 25223 146TH AVE SE, KENT, WA 98042-3410
- **Mailing address phone:** (425) 835-6512
- **Mailing address fax:** (253) 236-8730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/13/2020
- **Last updated:** 08/27/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2139440 | — | WA |