NPIMap

Organization Active NPI

Optum Care Washington PLLC

  • Community/Retail Pharmacy
  • Everett, WA
National Provider Identifier
1245300052
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF00056690 Issued in WA
Legal business name
OPTUM CARE WASHINGTON PLLC
Practice address
3909 Hoyt Ave
Everett, WA 98201-4918
Phone
(425) 317-3620
Fax
(425) 259-2857
NPI assigned
Nov 9, 2006
Organization subpart
Yes
Parent organization
EVERETT PHYSICIANS, INC. P.S.As reported in NPPES

National Provider Directory

National Provider Directory
Tax ID family
Everett Clinic30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
George Go, M.D.
Title
Board President
Phone
(425) 259-0966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X CF00056690 WA Primary

Addresses

Primary practice location

3909 Hoyt Ave
Everett, WA 98201-4918

Mailing address

PO Box 2747
Everett, WA 98213-0747
Phone (425) 317-3941

Other identifiers 2

IdentifierTypeStateIssuer
6023741MedicaidWA
4903692OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Optum-PHCY at Main Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 9, 2024.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1245300052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2747",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982130747",
            "telephone_number": "425-317-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 HOYT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014918",
            "telephone_number": "425-317-3620",
            "fax_number": "425-259-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM CARE WASHINGTON PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERETT PHYSICIANS, INC. P.S.",
        "enumeration_date": "2006-11-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "GO",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "425-259-0966",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00056690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6023741",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4903692",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum-PHCY at Main",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.