Individual provider Active NPI

Mary K Baskin-Thompson, MSN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Everett, WA
National Provider Identifier
1376608307
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP61014304 Issued in WA
Practice address
1728 W Marine View Dr Ste 6
Everett, WA 98201-2094
Phone
(425) 339-5453
Fax
(425) 252-4441
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC00002103 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61014304 WA Primary

Addresses

Primary practice location

1728 W Marine View Dr Ste 6
Everett, WA 98201-2094

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 304-4831

Other practice location 1

19410 36th Ave W Ste 9
Lynnwood, WA 98036-5747
Phone (425) 670-0970

Other practice location 2

1116 Summit Ave
Seattle, WA 98101-2831
Phone (206) 323-0930

Other practice location 3

325 W Gowe St
Kent, WA 98032-5892
Phone (253) 833-7444

Other identifiers 1

IdentifierTypeStateIssuer
2147839MedicaidWA

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
I20200217004759 WA Practitioner - Nurse Practitioner 2769819515 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

1330 Rockefeller Ave
Everett, WA 98201-1684
Phone (425) 259-0966

1728 W Marine View Dr
Everett, WA 98201-2094
Phone (425) 259-0966

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AC00002103WAMDAcupuncturist
AP61014304WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Jan 31, 2023 Accepting new patients
Optum Care Washington PLLC CurrentSince Jan 31, 2023 Accepting new patients
The Polyclinic PLLC CurrentSince May 11, 2025 Accepting new patients
Valley Cities Counseling and Consultation CurrentSince Jan 13, 2020 Accepting new patients
The Polyclinic PLLC CurrentSince May 11, 2025 Accepting new patients
Body Recovery Clinic LLC Past Accepting new patients

Locations

2704 I St NE
Auburn, WA 98002
Phone (253) 876-3415

1728 W Marine View Dr
Ste 6
Everett, WA 98201

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

1336 S 336th St
Federal Way, WA 98003
Phone (206) 887-3753

325 W Gowe St
Kent, WA 98032

1145 Broadway
Seattle, WA 98122

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

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: mbaskinthompson70996@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1376608307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-304-4831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 W MARINE VIEW DR STE 6",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012094",
            "telephone_number": "425-339-5453",
            "fax_number": "425-252-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19410 36th Ave W Ste 9",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980365747",
            "country_code": "US",
            "telephone_number": "425-670-0970",
            "fax_number": "425-670-0940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1116 Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981012831",
            "country_code": "US",
            "telephone_number": "206-323-0930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 W Gowe St",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "WA",
            "postal_code": "980325892",
            "country_code": "US",
            "telephone_number": "253-833-7444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASKIN-THOMPSON",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "MSN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WA",
            "license": "AC00002103",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61014304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2147839",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.