Individual provider Active NPI

Jacqueline Panko, M.D.

  • Dermatology Physician
  • Seattle, WA
National Provider Identifier
1366644478
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD60932004 Issued in WA
Practice address
1448 NW Market St
Seattle, WA 98107-3743
Phone
(206) 860-5596
Fax
(206) 720-7476
NPI assigned
Jun 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD60932004 WA Primary

Addresses

Primary practice location

1448 NW Market St
Seattle, WA 98107-3743

Mailing address

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

Other practice location 1

9709 3rd Ave NE
Seattle, WA 98115-2062
Phone (206) 860-2222

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200323002290 WA Practitioner - Dermatology 9739232521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Utah School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Practice addresses (Care Compare)

9709 3Rd Ave NE
Optum Northgate Plaza Urgent Care
Seattle, WA 98115-2077
Phone (206) 401-3191

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of skin lesions340
Removal or shaving of skin growth17
Skin biopsy198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC Current Accepting new patients
The Polyclinic PLLC Dermatology Current Accepting new patients
Optum Care Washington PLLC CurrentSince Apr 14, 2025 Accepting new patients
Optum Care Washington PLLC CurrentSince Apr 14, 2025 Accepting new patients
The Polyclinic PLLC CurrentSince Feb 8, 2020 Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

912 32nd St
Ste A
Anacortes, WA 98221
Phone (360) 293-4343

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1145 Broadway
Seattle, WA 98122

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1448 NW Market St
Seattle, WA 98107
Phone (206) 781-6353

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

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

Interoperability endpoints

  • Direct secure messaging: jpanko22968@direct.tecmc.com

Organizations & group practices 6

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": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1366644478",
    "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": "1448 NW MARKET ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073743",
            "telephone_number": "206-860-5596",
            "fax_number": "206-720-7476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9709 3rd Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981152062",
            "country_code": "US",
            "telephone_number": "206-860-2222",
            "fax_number": "206-720-7476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANKO",
        "first_name": "JACQUELINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-01",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD60932004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.