Active NPI
Optum Care Washington PLLC
- Internal Medicine Physician
- Anacortes, WA
National Provider Identifier
1629698964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- OPTUM CARE WASHINGTON PLLC
- Practice address
- 912 32ND St Ste a
Anacortes, WA 98221-3473 - Phone
- (360) 293-4343
- NPI assigned
- Apr 16, 2020
- Organization subpart
- Yes
- Parent organization
- EVERETT PHYSICIANS, INC. P.S.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- George Go, MD
- Title
- Board President
- Phone
- (425) 259-0966
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | Primary | ||
| Pediatrics Physician | 208000000X | |||
| Clinical Medical Laboratory | 291U00000X |
Addresses
Primary practice location
912 32ND St Ste a
Anacortes, WA 98221-3473
Mailing address
PO Box 5127
Everett, WA 98206-5127
Phone (360) 293-4343
Other names 1
- Optum - Island Internal Medicine
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D0869692 | Optum Care Washington, PLLC | Compliance | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586995200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712707200000",
"number": "1629698964",
"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": "360-293-4343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 32ND ST STE A",
"city": "ANACORTES",
"state": "WA",
"postal_code": "982213473",
"telephone_number": "360-293-4343"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OPTUM CARE WASHINGTON PLLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "EVERETT PHYSICIANS, INC. P.S.",
"enumeration_date": "2020-04-16",
"last_updated": "2024-04-10",
"certification_date": "2024-04-10",
"status": "A",
"authorized_official_last_name": "GO",
"authorized_official_first_name": "GEORGE",
"authorized_official_title_or_position": "BOARD PRESIDENT",
"authorized_official_telephone_number": "425-259-0966",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Optum - Island Internal Medicine",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Anacortes, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.