Individual provider Active NPI

Christian Herter, MD

  • Family Medicine Physician
  • Mill Creek, WA
National Provider Identifier
1619160223
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00026744 Issued in WA
Practice address
3916 148TH St SE
Mill Creek, WA 98012-4751
Phone
(425) 332-6948
Fax
(425) 304-1102
NPI assigned
Aug 27, 2007
Last updated
Jan 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00026744 WA Primary
Adult Medicine Physician 207QA0505X 26744 WA

Addresses

Primary practice location

3916 148TH St SE
Mill Creek, WA 98012-4751

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 332-6948

Other practice location 1

19116 33rd Ave W
Lynnwood, WA 98036-4706
Phone (425) 712-7900

Other identifiers 1

IdentifierTypeStateIssuer
8202764MedicaidWA

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
I20051230000658 WA Practitioner - Family Practice 0648292805 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26744WAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Snohomish County CurrentSince Feb 21, 2024 Accepting new patients
Community Health Center of Snohomish County Family Medicine CurrentSince Feb 21, 2024 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Nov 14, 2016 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Nov 14, 2016 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Optum Care Washington PLLC Family Medicine PastSince Jan 12, 2020 Accepting new patients

Locations

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

400 108th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 467-3785

23320 Highway 99
Edmonds, WA 98026
Phone (425) 640-5500

1019 112th St SW
Everett, WA 98204
Phone (425) 551-6001

4201 Rucker Ave
Everett, WA 98203
Phone (425) 382-4000

8609 Evergreen Way
Everett, WA 98208
Phone (425) 551-6200

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1619160223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-332-6948",
            "fax_number": "425-304-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 148TH ST SE",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980124751",
            "telephone_number": "425-332-6948",
            "fax_number": "425-304-1102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19116 33rd Ave W",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980364706",
            "country_code": "US",
            "telephone_number": "425-712-7900",
            "fax_number": "425-712-7903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERTER",
        "first_name": "CHRISTIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-27",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00026744",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "WA",
            "license": "26744",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8202764",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

Verify at the official NPI Registry.