Individual provider Active NPI

Sanjay Raj, MD

  • Pediatrics Physician
  • Everett, WA
National Provider Identifier
1477662278
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00040998 Issued in WA
Practice address
1430 Broadway
Everett, WA 98201-1720
Phone
(425) 789-3333
Fax
(425) 789-3320
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00040998 WA Primary

Addresses

Primary practice location

1430 Broadway
Everett, WA 98201-1720

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other practice location 1

3030 Limited Ln NW
Olympia, WA 98502-2704
Phone (604) 911-3993

Other identifiers 3

IdentifierTypeStateIssuer
A037OtherWATRICARE
8322539MedicaidWA
167384OtherWAWORK COMP

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
I20140925001207 WA Practitioner - Pediatric Medicine 6901032911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

3030 Limited LN NW
Olympia, WA 98502-2704
Phone (360) 491-1399

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00040998WAMDPediatrics Physician
55820CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Nov 19, 2019 Accepting new patients
Sea-Mar Community Health Center Past Accepting new patients

Locations

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

Interoperability endpoints

  • Direct secure messaging: sraj450750@direct.multicare.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1477662278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "fax_number": "425-789-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011720",
            "telephone_number": "425-789-3333",
            "fax_number": "425-789-3320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Limited Ln NW",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985022704",
            "country_code": "US",
            "telephone_number": "604-911-3993",
            "fax_number": "360-704-2914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJ",
        "first_name": "SANJAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00040998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A037",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8322539",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORK COMP",
            "identifier": "167384",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.