NPIMap

Organization Active NPI

Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Lynnwood, WA
National Provider Identifier
1477594356
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PACMED CLINICS
Practice address
19401 40TH Ave W
Suite 100
Lynnwood, WA 98036-4612
Phone
(425) 744-7153
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Authorized official

Name
Donald Wayne Anderson Jr.
Title
Assistant Secreatry for Enrollment
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

19401 40TH Ave W
Suite 100
Lynnwood, WA 98036-4612

Mailing address

19401 40TH Ave W
Suite 100
Lynnwood, WA 98036-4612
Phone (425) 744-7153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031226000033 WA Part B Supplier - Clinic/Group Practice 2466350657 Receives reassigned benefits from 294 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lynnwood, WA; Seattle, WA; Renton, WA; Puyallup, WA; Kirkland, WA; Issaquah, WA; Federal Way, WA; Bothell, WA

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

220 15th Ave SE
Ste C
Puyallup, WA 98372
Phone (253) 435-3400

Practitioners & affiliated clinicians

Practitioners 51

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

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746748800000",
    "number": "1477594356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19401 40TH AVE W",
            "address_2": "SUITE 100",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364612",
            "telephone_number": "425-744-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 40TH AVE W",
            "address_2": "SUITE 100",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364612",
            "telephone_number": "425-744-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACMED CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECREATRY FOR ENROLLMENT",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.