Organization Active NPI

Optum Care Washington PLLC

  • Internal Medicine Physician
  • Anacortes, WA
National Provider Identifier
1629698964
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
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.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0869692Optum Care Washington, PLLC912 32ND St Ste a, Anacortes, WA 98221ComplianceApr 4, 2028

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.