NPIMap

Organization Active NPI

The Polyclinic PLLC

  • Durable Medical Equipment & Medical Supplies
  • Seattle, WA
National Provider Identifier
1407236367
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
Practice address
509 Olive Way
Suite 900
Seattle, WA 98101-1720
Phone
(206) 329-1760
NPI assigned
Jun 5, 2015
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 Pepin
Title
Physician/Owner
Phone
(206) 860-5414

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

509 Olive Way
Suite 900
Seattle, WA 98101-1720

Mailing address

509 Olive Way
Suite 900
Seattle, WA 98101-1720
Phone (206) 329-1760

Other names 1

  • Optum - Madison Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Steffan Havas MD7 organizations share this tax ID, including this one
Part of
Steffan Havas MD

Other organizations with this tax ID 6

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

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": "1433462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1407236367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY",
            "address_2": "SUITE 900",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011720",
            "telephone_number": "206-329-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY",
            "address_2": "SUITE 900",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011720",
            "telephone_number": "206-329-1760"
        }
    ],
    "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": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum - Madison Center",
            "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.