Individual provider Active NPI

Carol H Hungerford, D.O

  • Family Medicine Physician
  • Puyallup, WA
National Provider Identifier
1134578222
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61483214 Issued in WA
Practice address
11019 Canyon Rd E
Puyallup, WA 98373-3001
Phone
(425) 259-0966
NPI assigned
Jun 8, 2016
Last updated
Jun 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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 1733 NE
Family Medicine Physician 207Q00000X DO2832 NV
Family Medicine Physician 207Q00000X OP61483214 WA Primary

Addresses

Primary practice location

11019 Canyon Rd E
Puyallup, WA 98373-3001

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other identifiers 2

IdentifierTypeStateIssuer
1134578222MedicaidNV
DO2832OtherNVSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, 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
I20210608001510 NV Practitioner - Family Practice 0648564054 Reassigns benefits to 1 organization
I20231205002258 WA Practitioner - Family Practice 0648564054 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP61483214WAMDFamily Medicine Physician
1733NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Family Medicine Current Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Dec 4, 2023 Accepting new patients
Intermountain Medical Holdings Nevada Inc Family Medicine CurrentSince Jan 1, 2022 Accepting new patients
Healthcare Partners Medical Group Coats LTD Family Medicine Current Accepting new patients
Intermountain Medical Holdings Nevada Inc CurrentSince Jan 1, 2022 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Dec 4, 2023 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Dec 4, 2023 Accepting new patients
The Polyclinic CurrentSince Dec 4, 2023 Accepting new patients

Locations

595 W Lake Mead Pkwy
Henderson, NV 89015
Phone (702) 566-5500

4880 Wynn Rd
Las Vegas, NV 89103
Phone (702) 382-4554

6170 N Durango Dr
Ste 130
Las Vegas, NV 89149
Phone (702) 940-1550

6355 S Buffalo Dr
Fl 3
Las Vegas, NV 89113
Phone (702) 479-4881

1397 S Loop Rd
Pahrump, NV 89048
Phone (775) 727-5500

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

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

Interoperability endpoints

  • Direct secure messaging: chungerford81971@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1134578222",
    "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": "11019 CANYON RD E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733001",
            "telephone_number": "425-259-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNGERFORD",
        "first_name": "CAROL",
        "middle_name": "H",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1733",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO2832",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61483214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134578222",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DO2832",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.