Active NPI
Jessica D Wissenbach, DO
- Family Medicine Physician
- Everett, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OP70013176
- Practice address
- 3901 Hoyt Ave
Everett, WA 98201-4918 - Phone
- (425) 339-5456
- Fax
- (425) 303-3091
- NPI assigned
- Mar 20, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 13516654-1204 | UT | |
| Family Medicine Physician | 207Q00000X | OP70013176 | WA | Primary |
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 practice location 1
904 7th Ave
Seattle, WA 98104-1132
Phone (206) 329-1760
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT, 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, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP70013176 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Polyclinic PLLC | Family Medicine | Current | Accepting new patients |
| Optum Care Washington PLLC | Family Medicine | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Optum Care Washington PLLC | Family Medicine | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients | |
| The Polyclinic PLLC | Family Medicine | Current | Accepting new patients |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Optum Care Washington PLLC | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
98 N 1100 E
Ste 101
Highland, UT 84003
Phone (801) 492-2273
475 W 940 N
Provo, UT 84604
Phone (801) 357-7909
395 W Cougar Blvd
Ste 205
Provo, UT 84604
Phone (801) 357-1770
3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903
1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903
3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419
1145 Broadway
Seattle, WA 98122
9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777
904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487
1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299
1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900
Interoperability endpoints
- jwissenbach98339@direct.tecmc.com
Organizations & group practices 8
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.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- Durable Medical Equipment & Medical Supplies
- Marysville, WA
- NPI 1194428425
Family Medicine
-
- Durable Medical Equipment & Medical Supplies
- Tacoma, WA
- NPI 1831411487
Family Medicine
-
- Allergy & Immunology Physician
- St George, UT
- NPI 1093958605
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Ambulatory Surgical Clinic/Center
- Everett, WA
- NPI 1154318103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1114676004",
"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": "425-339-5456",
"fax_number": "425-303-3091"
}
],
"practiceLocations": [
{
"address_1": "904 7th Ave",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981041132",
"country_code": "US",
"telephone_number": "206-329-1760",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WISSENBACH",
"first_name": "JESSICA",
"middle_name": "D",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-20",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "13516654-1204",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "OP70013176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Jul 22, 2026; 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.