NPIMap

Organization Active NPI

The Polyclinic PLLC

Doing business as Optum Care Washington

  • Durable Medical Equipment & Medical Supplies
  • Seattle, WA
National Provider Identifier
1346620200
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
THE POLYCLINIC PLLC
Doing business as
Optum Care Washington
The Polyclinic SandPoint
Practice address
3216 NE 45TH PL
Suite 200
Seattle, WA 98105-4093
Phone
(206) 525-4000
NPI assigned
Jun 5, 2015
Last updated
May 13, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
THE POLYCLINIC PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Authorized official

Name
Craig PepinNPI 1114995511
Title
Physician/Owner
Phone
(206) 860-5414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

3216 NE 45TH PL
Suite 200
Seattle, WA 98105-4093

Mailing address

3216 NE 45TH PL
Suite 200
Seattle, WA 98105-4093
Phone (206) 525-4000

Other names 2

  • Optum Care Washington Doing business as
  • The Polyclinic SandPoint Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Antonius G Mulia MD7 organizations share this tax ID, including this one
Part of
Antonius G Mulia MD

Other organizations with this tax ID 6

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

Locations

1229 Madison St
#1660
Seattle, WA 98104
Phone (206) 860-5582

3216 NE 45th Pl
Ste 200
Seattle, WA 98105
Phone (206) 525-4000

Practitioners & affiliated clinicians

Practitioners 385

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 385

NPI Registry JSON

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1346620200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 NE 45TH PL",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054093",
            "telephone_number": "206-525-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 NE 45TH PL",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054093",
            "telephone_number": "206-525-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE POLYCLINIC PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE POLYCLINIC PLLC",
        "enumeration_date": "2015-06-05",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "PEPIN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "206-860-5414"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum Care Washington",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Polyclinic SandPoint",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Polyclinic SandPoint",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.