Individual provider Active NPI

Lloyd Turla Licuanan, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1114019049
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61380771 Issued in WA
Practice address
9709 3Rd Ave NE
Seattle, WA 98115-2062
Phone
(206) 860-2222
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036123174 IL
Family Medicine Physician 207Q00000X T2006017510 MO
Family Medicine Physician 207Q00000X MD61380771 WA Primary

Addresses

Primary practice location

9709 3Rd Ave NE
Seattle, WA 98115-2062

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (206) 860-5414

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160401001885 CA Practitioner - Family Practice 0941331318 Reassigns benefits to 1 organization
I20231012002360 WA Practitioner - Family Practice 0941331318 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Practice addresses (Care Compare)

3927 Rucker Ave
Everett, WA 98201-4833
Phone (425) 259-0966

9709 3Rd Ave NE
Optum Northgate Plaza Urgent Care
Seattle, WA 98115-2077
Phone (206) 401-3191

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036123174ILMDFamily Medicine Physician
T2006017510MOMDFamily Medicine Physician
MD61380771WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Family Medicine Current Accepting new patients
Permanente Medical Group Inc Family Medicine Current Accepting new patients
Permanente Medical Group Inc Family Medicine CurrentSince Feb 17, 2016 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Feb 12, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Aug 29, 2023 Accepting new patients
The Polyclinic CurrentSince Feb 12, 2024 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Feb 12, 2024 Accepting new patients
Optum Care Washington PLLC CurrentSince Feb 12, 2024 Accepting new patients
Optum Care Washington PLLC Family Medicine Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Feb 17, 2016 Accepting new patients
The Polyclinic PLLC Family Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Aug 29, 2023 Accepting new patients
The Polyclinic PLLC Family Medicine Past Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

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

3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

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

12607 SE Mill Plain Blvd
Vancouver, WA 98684
Phone (360) 418-6001

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: llicuanan83482@direct.tecmc.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1114019049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9709 3RD AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152062",
            "telephone_number": "206-860-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICUANAN",
        "first_name": "LLOYD",
        "middle_name": "TURLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036123174",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "T2006017510",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61380771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "975 Sereno Dr",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945892441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.