Organization Active NPI

Northwest Family Care Clinic PLLC

  • Family Medicine Physician
  • Lacey, WA
National Provider Identifier
1386788537
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00001767 Issued in WA
Legal business name
NORTHWEST FAMILY CARE CLINIC PLLC
Practice address
5203 Lacey Blvd SE
Suite a
Lacey, WA 98503-7236
Phone
(360) 413-8447
Fax
(360) 413-8493
NPI assigned
Feb 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Huong Thi Lakin, D.O.NPI 1669430948
Title
Physician
Phone
(360) 413-8447

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OP00001767 WA Primary

Addresses

Primary practice location

5203 Lacey Blvd SE
Suite a
Lacey, WA 98503-7236

Mailing address

5203 Lacey Blvd SE
Suite a
Lacey, WA 98503-7236
Phone (360) 413-8447

Other identifiers 1

IdentifierTypeStateIssuer
8298416MedicaidWA

National Provider Directory

National Provider Directory

Locations

5203 Lacey Blvd SE
Ste A
Olympia, WA 98503
Phone (360) 413-8447

500 Lilly Rd NE
Ste 190
Olympia, WA 98506
Phone (360) 413-8447

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386788537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 LACEY BLVD SE",
            "address_2": "SUITE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985037236",
            "telephone_number": "360-413-8447",
            "fax_number": "360-413-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5203 LACEY BLVD SE",
            "address_2": "SUITE A",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985037236",
            "telephone_number": "360-413-8447",
            "fax_number": "360-413-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FAMILY CARE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LAKIN",
        "authorized_official_first_name": "HUONG",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "360-413-8447",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8298416",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.