Individual provider Active NPI

Jacqueline Blanche Berglass

  • Family Medicine Physician
  • Everett, WA
National Provider Identifier
1427611102
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61315834 Issued in WA
Practice address
3901 Hoyt Ave
Everett, WA 98201-4988
Phone
(425) 339-5456
Fax
(425) 303-3091
NPI assigned
Apr 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP61315834 WA Primary

Addresses

Primary practice location

3901 Hoyt Ave
Everett, WA 98201-4988

Mailing address

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

Other practice location 1

904 7th Ave
Seattle, WA 98104-1132
Phone (206) 329-1760

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
I20221116001260 WA Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 8820323942 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Philadelphia College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

904 7TH Ave
Seattle, WA 98104-1132
Phone (206) 309-1760

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC Family Medicine CurrentSince Oct 23, 2023 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Oct 23, 2023 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Oct 23, 2023 Accepting new patients
Community Health Center of Snohomish County Family Medicine CurrentSince Oct 10, 2022 Accepting new patients
Community Health Center of Snohomish County CurrentSince Oct 10, 2022 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Oct 23, 2023 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
The Polyclinic PLLC Family Medicine Past Accepting new patients

Locations

3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903

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

1424 Broadway
Everett, WA 98201
Phone (425) 551-1000

8609 Evergreen Way
Everett, WA 98208
Phone (425) 551-6200

1019 112th St SW
Everett, WA 98204
Phone (425) 551-6001

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: jberglass81236@direct.tecmc.com

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1427611102",
    "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": "3901 HOYT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014988",
            "telephone_number": "425-339-5456",
            "fax_number": "425-303-3091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981041132",
            "country_code": "US",
            "telephone_number": "206-329-1760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGLASS",
        "first_name": "JACQUELINE",
        "middle_name": "BLANCHE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61315834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.