Optum Care Washington PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

OPTUM CARE WASHINGTON PLLC

Practice address

528 Myrtle Street
Laconner, WA 98257

Phone

(360) 466-3136

NPI assigned

Apr 16, 2020

Last updated

Apr 9, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

EVERETT PHYSICIANS, INC. P.S.As reported in NPPES

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

Authorized official

Name

Dr. George Go, MD

Title

Board President

Phone

(425) 259-0966

Specialties & licenses 4

Addresses

Other names 1

• Optum - La Conner Medical Center Other name

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

CLIA laboratory certificates

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1255950572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "360-466-3136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 MYRTLE STREET",
            "city": "LACONNER",
            "state": "WA",
            "postal_code": "98257",
            "telephone_number": "360-466-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM CARE WASHINGTON PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERETT PHYSICIANS, INC. P.S.",
        "enumeration_date": "2020-04-16",
        "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_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum - La Conner Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cynthia Melisa McCannel, RDH
• Sarah Miller, ARNP, FNP-C
• Lindsey Monica Montileaux Mabbutt, DDS, MPH
• Thanh Nguyen
• Leah Reiko Nystrom
• Bennett Wayne Pafford, M.D.
• Reidun E Pederson, RN
• Rene Amelia Pinkham, LMP MA 60485559
• Pure Joy Naturopathic Medicine
• Larry Joseph Quesnell, D.D.S.

• Internal Medicine Physician in La Conner, WA
• Providers in La Conner, WA by specialty
• Internal Medicine Physician in Washington

• 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.
• 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.