NPIMap

Organization Active NPI

Northshore Health PLLC

  • Addiction Medicine (Preventive Medicine) Physician
  • Bothell, WA
National Provider Identifier
1508692369
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
Legal business name
NORTHSHORE HEALTH PLLC
Practice address
12900 NE 180TH St
Bothell, WA 98011-5773
Phone
(425) 424-2100
NPI assigned
Sep 10, 2024
Last updated
Jun 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Authorized official

Name
Ananda UsmanNPI 1689342065
Title
Owner
Phone
(425) 424-2100

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X NU Primary

Addresses

Primary practice location

12900 NE 180TH St
Bothell, WA 98011-5773

Mailing address

PO Box 5824
Belfast, ME 04915-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250327001030 WA Part B Supplier - Clinic/Group Practice 9931622214 Receives reassigned benefits from 3 practitioners
Practice locations: Bothell, WA

National Provider Directory

National Provider Directory

Locations

12900 NE 180th St
Ste 100
Bothell, WA 98011
Phone (425) 398-9355

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1508692369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5824",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049155800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 NE 180TH ST",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980115773",
            "telephone_number": "425-424-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-10",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "USMAN",
        "authorized_official_first_name": "ANANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-424-2100"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.