Organization Active NPI

C J Kuan MD Inc PS

Doing business as North Sound Kidney Physicians

  • Nephrology Physician
  • Everett, WA
National Provider Identifier
1053592022
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD00031127 Issued in WA
Legal business name
C J KUAN MD INC PS
Doing business as
North Sound Kidney Physicians
Practice address
1111 Pacific Ave Ste B
Everett, WA 98201-4200
Phone
(360) 982-2210
Fax
(251) 286-2102
NPI assigned
Nov 19, 2007
Last updated
Sep 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Authorized official

Name
Chia-Jen Kuan, MDNPI 1114031655
Title
Physician / President
Phone
(360) 982-2210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD00031127 WA Primary

Addresses

Primary practice location

1111 Pacific Ave Ste B
Everett, WA 98201-4200

Mailing address

PO Box 5182
Everett, WA 98206-5182
Phone (360) 982-2210

Other practice location 1

1500 E Broadway
Mount Vernon, WA 98274-4523
Phone (360) 982-2210

Other identifiers 1

IdentifierTypeStateIssuer
1114883MedicaidWA

Other names 1

  • North Sound Kidney Physicians Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318000138 WA Part B Supplier - Clinic/Group Practice 2365332830 Receives reassigned benefits from 2 practitioners
Practice locations: Everett, WA; Mount Vernon, WA

National Provider Directory

National Provider Directory

Locations

1213 24th St
Ste 600
Anacortes, WA 98221
Phone (360) 293-2173

1111 Pacific Ave
Ste 2
Everett, WA 98201
Phone (360) 734-8204

3125 Colby Ave
Everett, WA 98201
Phone (425) 778-1505

8130 Evergreen Way
Everett, WA 98203
Phone (425) 353-6036

1500 E Broadway
Mount Vernon, WA 98274
Phone (360) 982-2210

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1053592022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5182",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065182",
            "telephone_number": "360-982-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 PACIFIC AVE STE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014200",
            "telephone_number": "360-982-2210",
            "fax_number": "251-286-2102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Broadway",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744523",
            "country_code": "US",
            "telephone_number": "360-982-2210",
            "fax_number": "360-982-2502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "C J KUAN MD INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "KUAN",
        "authorized_official_first_name": "CHIA-JEN",
        "authorized_official_title_or_position": "PHYSICIAN / PRESIDENT",
        "authorized_official_telephone_number": "360-982-2210",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD00031127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114883",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Sound Kidney Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.