Edmonds Family Care, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

602496426 Issued in WA

Legal business name

EDMONDS FAMILY CARE, PLLC

Practice address

6101 200TH St SW
Ste#208
Lynnwood, WA 98036-6077

Phone

(425) 775-2066

Fax

(425) 775-5306

NPI assigned

Feb 28, 2007

Last updated

Nov 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Svetlana A Bugaichuk

Title

Office Manager

Phone

(425) 775-2066

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tanya I Bryant, M.D.

  • Family Medicine Physician
  • Lynnwood, WA
  • NPI 1194739987
  Medicare reassignment NPD
• Dina Victorovna Shepelyuk, DNP, FNP-BC

  • Family Nurse Practitioner
  • Everett, WA
  • NPI 1407428097
  Medicare reassignment NPD
• Kara Harrington Brennan, MSN, ARNP-BC

  • Adult Health Nurse Practitioner
  • Bellevue, WA
  • NPI 1003245432
  NPD (past)
• Grace Kay Chao, PAC

  • Physician Assistant
  • Seattle, WA
  • NPI 1134496862
  NPD (past)
• Amber Farook, M.D.

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1588958599
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1184751638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 200TH ST SW",
            "address_2": "STE#208",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366077",
            "telephone_number": "425-775-2066",
            "fax_number": "425-775-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 200TH ST SW",
            "address_2": "STE#208",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366077",
            "telephone_number": "425-775-2066",
            "fax_number": "425-775-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMONDS FAMILY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "BUGAICHUK",
        "authorized_official_first_name": "SVETLANA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-775-2066"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "602496426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR&INDUSTRIES",
            "identifier": "0199257",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7128606",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eden Hospice at Snohomish County, LLC (Eden Hospice)
• Sarah Eden, MOT
• Brian Edge, LMP
• Brynn Esterra Edmark
• Edmonds Community College
• Edmonds School District
• Edmonds School District
• Zoe R Edris, RN
• Edward H. Perkl, DDS, PS
• Annie Edwards

• Primary Care Clinic/Center in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.