Individual provider Active NPI

Emmy Nakasu Davison, M.D.

  • Family Medicine Physician
  • Edmonds, WA
National Provider Identifier
1124382676
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60490100 Issued in WA
Practice address
21911 76TH Ave W
Suite 110
Edmonds, WA 98026-7918
Phone
(425) 640-4950
Fax
(425) 640-4958
NPI assigned
Jun 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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 ML60293604 WA
Family Medicine Physician 207Q00000X MD60490100 WA Primary

Addresses

Primary practice location

21911 76TH Ave W
Suite 110
Edmonds, WA 98026-7918

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 2

IdentifierTypeStateIssuer
ML60293604OtherWALIMITED MEDICAL LICENSE NUMBER
2020610MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edavison1041425@wm.providencedirect.org Direct

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
I20160205000734 WA Practitioner - Family Practice 4284946872 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

21911 76TH Ave W
Suite 110
Edmonds, WA 98026-7918
Phone (425) 640-4950

Hospital & facility affiliations

  • Evergreenhealth Home Care Services Home health agency, Kirkland, WA, CCN 507079
  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60490100WAMDFamily Medicine Physician
ML60293604WAMDFamily Medicine Physician
100681AKMDNursing Home Administrator

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services CurrentSince Oct 1, 2016 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Apr 18, 2016 Accepting new patients
Swedish Health Services Family Medicine CurrentSince Oct 1, 2016 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Apr 18, 2016 Accepting new patients
Neighborcare Health CurrentSince Aug 24, 2015 Accepting new patients
Neighborcare Health CurrentSince Aug 24, 2015 Accepting new patients
Neighborcare Health Current Accepting new patients
Swedish Edmonds Past Accepting new patients

Locations

21911 76th Ave W
Ste 110
Edmonds, WA 98026
Phone (425) 640-4950

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

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

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

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

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 600
Seattle, WA 98104

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

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: edavison1041425@wm.providencedirect.org

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.

Hospital & facility affiliations 3

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": "1340928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1124382676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21911 76TH AVE W",
            "address_2": "SUITE 110",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267918",
            "telephone_number": "425-640-4950",
            "fax_number": "425-640-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "EMMY",
        "middle_name": "NAKASU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-29",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML60293604",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60490100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIMITED MEDICAL LICENSE NUMBER",
            "identifier": "ML60293604",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2020610",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edavison1041425@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21911 76th Ave W",
            "address_2": "Suite 110",
            "city": "Edmonds",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980267918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.