Individual provider Active NPI

Joe Gonzales, ARNP

  • Family Nurse Practitioner
  • Olympia, WA
National Provider Identifier
1336790070
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61417695 Issued in WA
Practice address
3622 Ensign Rd NE
Olympia, WA 98506-5081
Phone
(360) 742-5000
Fax
(360) 742-5019
NPI assigned
Sep 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP61417695 WA
Registered Nurse 163W00000X RN00166711 WA
Family Nurse Practitioner 363LF0000X AP61417695 WA Primary

Addresses

Primary practice location

3622 Ensign Rd NE
Olympia, WA 98506-5081

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other identifiers 1

IdentifierTypeStateIssuer
2141682MedicaidWA

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
I20231212000129 WA Practitioner - Nurse Practitioner 4981053311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

3622 Ensign Rd NE
Olympia, WA 98506-5081
Phone (360) 742-5000

Hospital & facility affiliations

  • El Centro Regional Medical Center Hospital, El Centro, CA, CCN 050045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN00166711WAMDRegistered Nurse
AP61417695WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Family Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Dec 18, 2025 Accepting new patients

Locations

515 W Main St
Elma, WA 98541
Phone (360) 482-5298

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

3622 Ensign Rd NE
Olympia, WA 98506
Phone (360) 742-5000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1336790070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 ENSIGN RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065081",
            "telephone_number": "360-742-5000",
            "fax_number": "360-742-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JOE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-24",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP61417695",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00166711",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61417695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2141682",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.