Individual provider Active NPI

Kay L Moua, ARNP

  • Nurse Practitioner
  • Everett, WA
National Provider Identifier
1073890737
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60236013 Issued in WA
Practice address
3901 Hoyt Ave
Everett, WA 98201-4918
Phone
(206) 860-5414
NPI assigned
Nov 9, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60236013 WA Primary
Nurse Practitioner 363L00000X RN00157937 WA

Addresses

Primary practice location

3901 Hoyt Ave
Everett, WA 98201-4918

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other identifiers 3

IdentifierTypeStateIssuer
2125115MedicaidWA
AP60236013OtherWALICENSE
2015343MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@premierdiabetescare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120206000378 WA Practitioner - Nurse Practitioner 9739346677 Reassigns benefits to 2 organizations
I20200404000547 TX Practitioner - Nurse Practitioner 9739346677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Nov 8, 2011 Accepting new patients
Tulalip Tribes of Washington Current Accepting new patients
Optum Care Washington PLLC CurrentSince Nov 8, 2011 Accepting new patients
The Polyclinic PLLC CurrentSince Dec 28, 2025 Accepting new patients
Tulalip Tribes of Washington CurrentSince Feb 24, 2020 Accepting new patients
Tulalip Tribes of Washington CurrentSince Feb 24, 2020 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1145 Broadway
Seattle, WA 98122

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900

7520 Totem Beach Rd
Tulalip, WA 98271
Phone (360) 651-4511

6406 Marine Dr
Ste A
Tulalip, WA 98271

Interoperability endpoints

  • Direct secure messaging: kmoua12179@direct.tecmc.com

Organizations & group practices 9

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1073890737",
    "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": "3901 HOYT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014918",
            "telephone_number": "206-860-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUA",
        "first_name": "KAY",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60236013",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "RN00157937",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2125115",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP60236013",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015343",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@premierdiabetescare.com",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "16404 Smokey Point Blvd",
            "address_2": "Suite 102",
            "city": "Arlington",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.