Kelly P Grenner, ARNP-FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61085959 Issued in WA

Practice address

10025 NE 186TH St
Bothell, WA 98011-3839

Phone

(425) 486-9131

Fax

(425) 486-9490

NPI assigned

Jul 14, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgrenner70186@direct.tecmc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766

  Family Medicine

  Medicare reassignment Care Compare group NPD
• King County Public Hospital District No 2

  dba Booth Gardner Parkinsons Care Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment NPD
• The Polyclinic PLLC

  dba Optum - Broadway

  • Audiologist
  • Seattle, WA
  • NPI 1174594634

  Family Medicine

  Medicare reassignment NPD
• King County Public Hospital District No 2

  dba EvergreenHealth Medical Group Snohomish County

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1902907165
  NPD
• King County Public Hospital District No. 2

  dba EvergreenHealth at Home Physical Therapy

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• King County Public Hospital District No. 2

  dba EvergreenHealth Medical Group King County

  • Clinic/Center
  • Redmond, WA
  • NPI 1750612883

  Family Medicine

  NPD
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425

  Family Medicine

  NPD
• The Polyclinic PLLC

  dba Optum Tacoma

  • Durable Medical Equipment & Medical Supplies
  • Tacoma, WA
  • NPI 1831411487

  Family Medicine

  NPD
• King County Public Hospital District No 2

  dba Evergreen Healthcare OB Hospitalists

  • Obstetrics Physician
  • Kirkland, WA
  • NPI 1891883435
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1003424128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10025 NE 186TH ST",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113839",
            "telephone_number": "425-486-9131",
            "fax_number": "425-486-9490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22850 NE 8th St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Sammamish",
            "state": "WA",
            "postal_code": "980747256",
            "country_code": "US",
            "telephone_number": "425-898-0305",
            "fax_number": "425-898-8825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15424 NE 160th St",
            "address_purpose": "LOCATION",
            "city": "Woodinville",
            "state": "WA",
            "postal_code": "980728180",
            "country_code": "US",
            "telephone_number": "206-351-1231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15424 NE 160th St",
            "address_purpose": "LOCATION",
            "city": "Woodinville",
            "state": "WA",
            "postal_code": "980728180",
            "country_code": "US",
            "telephone_number": "206-351-1231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRENNER",
        "first_name": "KELLY",
        "middle_name": "P",
        "credential": "ARNP-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61085959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shellie Gravitt, LMFT
• Hannah Elizabeth Greene
• Erika Laine Greenup
• Gregory G. Wang, DDS, PLLC
• April Sotelo Greninger, MS
• Kristina A Grey, DDS, MSD
• Mallory Griffin, RN
• Nova Griffin, LMT
• Jennifer Griner
• Patricia Groebner, OTRL

• Family Nurse Practitioner in Bothell, WA
• Providers in Bothell, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.