Active NPI
Sanjay Raj, MD
- Pediatrics Physician
- Everett, WA
National Provider Identifier
1477662278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD00040998
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A037 | Other | WA | TRICARE |
| 8322539 | Medicaid | WA | |
| 167384 | Other | WA | WORK 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD00040998 | WA | MD | Pediatrics Physician |
| 55820 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sea Mar Community Health Centers | Current | Accepting new patients | |
| Sea Mar Community Health Centers | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Aberdeen, WA
- NPI 1811051170
-
- Federally Qualified Health Center (FQHC)
- Lacey, WA
- NPI 1700101797
-
- Family Medicine Physician
- Seattle, WA
- NPI 1942358817
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.