NPIMap

Organization Active NPI

Life Changes Health Care Clinic

  • Nurse Practitioner
  • Everett, WA
National Provider Identifier
1477614311
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30006112 Issued in WA
Legal business name
LIFE CHANGES HEALTH CARE CLINIC
Practice address
2820 Hewitt Ave
Everett, WA 98201-3820
Phone
(425) 252-6484
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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

Authorized official

Name
Dr. Lyndon C Capon, MD, ARNP, NDNPI 1821083056
Title
Chief Medical Officer
Phone
(425) 750-0881

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X NT00000478 WA
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X AP30006112 WA Primary

Addresses

Primary practice location

2820 Hewitt Ave
Everett, WA 98201-3820

Mailing address

PO Box 12608
Mill Creek, WA 98082-0608
Phone (425) 252-6484

National Provider Directory

National Provider Directory

Locations

2820 Hewitt Ave
Everett, WA 98201
Phone (425) 252-6484

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": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184803200000",
    "number": "1477614311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12608",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980820608",
            "telephone_number": "425-252-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 HEWITT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013820",
            "telephone_number": "425-252-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHANGES HEALTH CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-19",
        "status": "A",
        "authorized_official_last_name": "CAPON",
        "authorized_official_first_name": "LYNDON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "425-750-0881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, ARNP, ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT00000478",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; 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.