Individual provider Active NPI

Ronnie Okialda, PNP

  • Pediatric Nurse Practitioner
  • Marysville, WA
National Provider Identifier
1265513451
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP30007421 Issued in WA
Practice address
4420 76TH St NE
Marysville, WA 98270-3726
Phone
(360) 651-7492
Fax
(360) 651-7482
NPI assigned
Oct 17, 2006
Last updated
May 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN00155465 WA
Pediatric Nurse Practitioner 363LP0200X AP30007421 WA Primary

Addresses

Primary practice location

4420 76TH St NE
Marysville, WA 98270-3726

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181105002577 WA Practitioner - Nurse Practitioner 1557614799 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30007421WAMDPediatric Nurse Practitioner
RN00155465WAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC CurrentSince Jan 14, 2026 Accepting new patients
The Polyclinic PLLC CurrentSince Jan 14, 2026 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

1145 Broadway
Seattle, WA 98122

1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900

Interoperability endpoints

  • Direct secure messaging: rokialda16967@direct.tecmc.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1265513451",
    "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": "4420 76TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982703726",
            "telephone_number": "360-651-7492",
            "fax_number": "360-651-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKIALDA",
        "first_name": "RONNIE",
        "name_prefix": "Mr.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "RN00155465",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP30007421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

Verify at the official NPI Registry.