Organization Active NPI

Northwest Health & Healing PLLC

Doing business as Northwest Health & Healing

  • Family Nurse Practitioner
  • Stanwood, WA
National Provider Identifier
1366298861
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
NORTHWEST HEALTH & HEALING PLLC
Doing business as
Northwest Health & Healing
Practice address
7202 267TH St NW Ste 104
Stanwood, WA 98292-6270
Phone
(425) 263-1189
Fax
(833) 428-3954
NPI assigned
Apr 25, 2024
Last updated
Jan 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
George Nicolaas Wagner
Title
Practice Manager
Phone
(425) 299-3365

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X
General Practice Registered Nurse 163WG0000X

Addresses

Primary practice location

7202 267TH St NW Ste 104
Stanwood, WA 98292-6270

Mailing address

PO Box 808
Stanwood, WA 98292-0808
Phone (425) 263-1189

Other names 1

  • Northwest Health & Healing Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241022003736 WA Part B Supplier - Clinic/Group Practice 1759813231 Receives reassigned benefits from 1 practitioner
Practice locations: Stanwood, WA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2304577Northwest Health and Healing7202 267TH Place Northwest Ste #104, Stanwood, WA 98292Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

7202 267th St NW
Ste 104
Stanwood, WA 98292
Phone (425) 263-1189

9229 271st St NW
Unit 808
Stanwood, WA 98292

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1366298861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 808",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982920808",
            "telephone_number": "425-263-1189",
            "fax_number": "833-428-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7202 267TH ST NW STE 104",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982926270",
            "telephone_number": "425-263-1189",
            "fax_number": "833-428-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST HEALTH & HEALING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "NICOLAAS",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "425-299-3365"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Health & Healing",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northwest Health & Healing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stanwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.