Option 1 Northwest Enteral LLC

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

Legal business name

OPTION 1 NORTHWEST ENTERAL LLC

Practice address

8633 South 212TH Street
Kent, WA 98031

Phone

(888) 885-2386

Fax

(888) 599-3448

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Matthew Buckhalter

Title

Cfo

Phone

(470) 464-8000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Aveanna Healthcare Medical Solutions Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Option 1 Northwest Enteral, LLC

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Beaverton, OR
  • NPI 1912101783

  7012111537

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Aveanna Healthcare Medical Solutions2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Option 1 Northwest Enteral, LLC

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Beaverton, OR
  • NPI 1912101783
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Jean Nelson, RD

  • Registered Dietitian
  • Kent, WA
  • NPI 1649580184
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1043398407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 INTERSTATE NORTH PKWY SE STE 1600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303395047",
            "telephone_number": "470-464-8000",
            "fax_number": "770-248-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8633 SOUTH 212TH STREET",
            "city": "KENT",
            "state": "WA",
            "postal_code": "98031",
            "telephone_number": "888-885-2386",
            "fax_number": "888-599-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTION 1 NORTHWEST ENTERAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "BUCKHALTER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "470-464-8000"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9058462",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9058470-02",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aveanna Healthcare Medical Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie Christine Onefeather, LMP
• Onestop Medical Services LLC
• Efe Linda Onuegbu, HIGH SCHOOL CER
• Onyx Pharmacy, Inc.
• Roseline Tutuaa Oppong
• Helena Orbach, M.D.
• Thomas P Oresman, P.A.- C
• Sean Orpen, LMFT
• Graciela J Ortiz
• Mary Ortiz

• Parenteral & Enteral Nutrition Supplies (DME) in Kent, WA
• Providers in Kent, WA by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.