NPIMap

Organization Active NPI

Primary Care Northwest, PLLC

  • Family Medicine Physician
  • Tacoma, WA
National Provider Identifier
1609849504
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMARY CARE NORTHWEST, PLLC
Practice address
1812 S J St
#102
Tacoma, WA 98405-4964
Phone
(253) 552-4900
Fax
(253) 627-1886
NPI assigned
Feb 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Authorized official

Name
Kim Nagel
Title
Practice Manager
Phone
(253) 552-5301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1812 S J St
#102
Tacoma, WA 98405-4964

Mailing address

1812 S J St
#102
Tacoma, WA 98405-4964
Phone (253) 552-4900

Other identifiers 1

IdentifierTypeStateIssuer
7097306MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1609849504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 S J ST",
            "address_2": "#102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054964",
            "telephone_number": "253-552-4900",
            "fax_number": "253-627-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 S J ST",
            "address_2": "#102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054964",
            "telephone_number": "253-552-4900",
            "fax_number": "253-627-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE NORTHWEST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "NAGEL",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "253-552-5301"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7097306",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.