Individual provider Active NPI

Kathleen Eiko Tubridy, MD

  • Family Medicine Physician
  • Bothell, WA
National Provider Identifier
1124258876
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60238358 Issued in WA
Practice address
10414 Beardslee Blvd Ste 100
Bothell, WA 98011-3205
Phone
(425) 486-0658
Fax
(425) 487-6761
NPI assigned
Jul 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0052409 CO
Family Medicine Physician 207Q00000X MD60238358 WA Primary

Addresses

Primary practice location

10414 Beardslee Blvd Ste 100
Bothell, WA 98011-3205

Mailing address

955 Powell Ave SW
Renton, WA 98057-2908
Phone (425) 277-1311

Other practice location 1

12721 30th Ave NE Ste 101
Seattle, WA 98125-4498
Phone (206) 417-0326

Other practice location 2

4410 106th St SW
Mukilteo, WA 98275-4700
Phone (425) 259-0966

Other identifiers 1

IdentifierTypeStateIssuer
1124258876MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130313000101 WA Practitioner - Family Practice 6002061363 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HealthpointGroup PAC ID 9335042886, 175 clinicians

Practice addresses (Care Compare)

10414 Beardslee Blvd
Bothell, WA 98011-3205
Phone (425) 486-0658

16255 NE 87TH St
Redmond, WA 98052-7391
Phone (425) 882-1697

26401 Pacific Hwy S
Des Moines, WA 98198
Phone (206) 870-3590

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0052409COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Jan 2, 2019 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Nov 21, 2022 Accepting new patients
Healthpoint CurrentSince Feb 10, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Neighborcare Health CurrentSince Sep 6, 2016 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 2, 2019 Accepting new patients
Neighborcare Health Current Accepting new patients
Neighborcare Health CurrentSince Sep 6, 2016 Accepting new patients
Healthpoint Family Medicine Current Accepting new patients
Neighborcare Health Current Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Nov 21, 2022 Accepting new patients
Healthpoint Family Medicine Past Accepting new patients

Locations

126 Auburn Ave
Ste 300
Auburn, WA 98002
Phone (253) 735-0166

10414 Beardslee Blvd
Ste 100
Bothell, WA 98011
Phone (425) 486-0658

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

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

33431 13th Pl S
Federal Way, WA 98003
Phone (253) 874-7634

403 E Meeker St
Ste 200
Kent, WA 98030
Phone (253) 852-2866

4410 106th St SW
Mukilteo, WA 98275
Phone (206) 388-6000

955 Powell Ave SW
Renton, WA 98057
Phone (253) 735-0166

200 S 2nd St
Renton, WA 98057
Phone (425) 226-5536

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

201 16th Ave E
Seattle, WA 98112
Phone (206) 326-4545

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

1200 12th Ave S
Ste 901
Seattle, WA 98144
Phone (206) 548-3058

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

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

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: ktubridy217515@ghc.direct-ci.net

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1124258876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 POWELL AVE SW",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572908",
            "telephone_number": "425-277-1311",
            "fax_number": "425-277-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10414 BEARDSLEE BLVD STE 100",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113205",
            "telephone_number": "425-486-0658",
            "fax_number": "425-487-6761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12721 30th Ave NE Ste 101",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981254498",
            "country_code": "US",
            "telephone_number": "206-417-0326",
            "fax_number": "206-417-0783",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4410 106th St SW",
            "address_purpose": "LOCATION",
            "city": "Mukilteo",
            "state": "WA",
            "postal_code": "982754700",
            "country_code": "US",
            "telephone_number": "425-259-0966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUBRIDY",
        "first_name": "KATHLEEN",
        "middle_name": "EIKO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0052409",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60238358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124258876",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

Verify at the official NPI Registry.