Randall Lee De Jong, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP30004081 Issued in WA

Practice address

916 Pacific Ave
1 South
Everett, WA 98201-4147

Phone

(425) 258-7390

Fax

(425) 258-7379

NPI assigned

Oct 20, 2006

Last updated

Nov 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services-WaGroup PAC ID 0648330787, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Providence Health & Services-Wa

  • Mammography Clinic/Center
  • Everett, WA
  • NPI 1336390442
  Medicare reassignment Care Compare group NPD
• Providence Health & Services-Wa

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Everett, WA
  • NPI 1033360144

  Psychiatric/Mental Health

  NPD
• Providence Health & Services-Washington

  dba Providence Surgery Center, Pacific Campus

  • Ambulatory Surgical Clinic/Center
  • Everett, WA
  • NPI 1588294854
  NPD
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services-Wa

  dba Providence Regional Medical Center Everett

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1285716761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 N BROADWAY",
            "address_2": "PBO",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011409",
            "telephone_number": "425-317-0699",
            "fax_number": "425-317-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 PACIFIC AVE",
            "address_2": "1 SOUTH",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014147",
            "telephone_number": "425-258-7390",
            "fax_number": "425-258-7379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JONG",
        "first_name": "RANDALL",
        "middle_name": "LEE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30004081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9631052",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdejong126634@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "916 Pacific Ave",
            "address_2": "1 South",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982014147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyla Gwyn Posada Dayag
• Daylight Psychiatric Care PLLC
• Michael Charles Daza
• Nicholas B. De Chadenedes, MD
• Jasmijn De Jong, RN
• Katrina De la Cruz, OTR/L
• Francisco Alexander De la Fuente, MD
• Susana De la Fuente, RDN
• Ana Lynn P De la Rosa
• Therese Nicole De la Torre, RN

• Psychiatric/Mental Health Nurse Practitioner in Everett, WA
• Providers in Everett, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.