Active NPI
Lloyd Turla Licuanan, MD
- Family Medicine Physician
- Seattle, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD61380771
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036123174 | IL | MD | Family Medicine Physician |
| T2006017510 | MO | MD | Family Medicine Physician |
| MD61380771 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New 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 | Current | Accepting new patients |
| The Polyclinic PLLC | Family Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Family Medicine | Current | Accepting new patients |
| The Polyclinic | Current | Accepting new patients | |
| Optum Care Washington PLLC | Family Medicine | Current | Accepting new patients |
| Optum Care Washington PLLC | Current | Accepting new patients | |
| Optum Care Washington PLLC | Family Medicine | Current | Accepting new patients |
| Permanente Medical Group, Inc | Current | Accepting new patients | |
| The Polyclinic PLLC | Family Medicine | Current | Accepting new patients |
| Kaiser Foundation Health Plan of the Northwest | Current | 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
- 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.
-
- General Practice Physician
- Portland, OR
- NPI 1184786527
Family Medicine, WA
-
- Internal Medicine Physician
- Santa Clara, CA
- NPI 1073606299
Family Medicine
-
- Durable Medical Equipment & Medical Supplies
- Marysville, WA
- NPI 1194428425
Family Medicine
-
- Ambulatory Surgical Clinic/Center
- Arlington, WA
- NPI 1366154304
-
- Radiation Oncology Physician
- Seattle, WA
- NPI 1962824219
-
- Durable Medical Equipment & Medical Supplies
- Tacoma, WA
- NPI 1831411487
Family Medicine
-
- General Practice Physician
- Portland, OR
- NPI 1871848457
Family Medicine
-
- Clinic/Center
- Hillsboro, OR
- NPI 1942718622
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1841373800
Family Medicine
-
- Clinical Medical Laboratory
- San Jose, CA
- NPI 1497971584
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; 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.