Organization Active NPI

Lake Cavanaugh Wellness

  • Clinic/Center
  • Mount Vernon, WA
National Provider Identifier
1174483937
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LAKE CAVANAUGH WELLNESS
Practice address
35206 Phipps Dr
Mount Vernon, WA 98274-8223
Phone
(360) 224-3222
NPI assigned
Nov 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Authorized official

Name
Sarah Schulke, NPNPI 1811712425
Title
NP
Phone
(360) 224-3222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

35206 Phipps Dr
Mount Vernon, WA 98274-8223

Mailing address

35206 Phipps Dr
Mount Vernon, WA 98274-8223
Phone (360) 224-3222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260102002702 WA Part B Supplier - Clinic/Group Practice 7214423888 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Vernon, WA

National Provider Directory

National Provider Directory
Tax ID family
Lake Cavanaugh Wellness2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1763078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1174483937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35206 PHIPPS DR",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982748223",
            "telephone_number": "360-224-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35206 PHIPPS DR",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982748223",
            "telephone_number": "360-224-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CAVANAUGH WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-14",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "SCHULKE",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "360-224-3222",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.