Individual provider Active NPI

Anika Cole Gannon, CNM, DNP, ARNP

  • Nurse Practitioner
  • Everett, WA
National Provider Identifier
1649945940
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP61169082 Issued in WA
Practice address
900 Pacific Ave FL 5
Everett, WA 98201-4168
Phone
(425) 339-5430
Fax
(425) 339-5454
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X RN60867666 WA
Nurse Practitioner 363L00000X AP61169082 WA Primary
Advanced Practice Midwife 367A00000X AP61169082 WA

Addresses

Primary practice location

900 Pacific Ave FL 5
Everett, WA 98201-4168

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230316000780 WA Practitioner - Nurse Practitioner 4284008111 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

900 Pacific Ave
Everett, WA 98201-4168
Phone (425) 339-5430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN60867666WAMDAmbulatory Women's Health Care Registered Nurse
AP61169082WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Current Accepting new patients
Optum Care Washington PLLC CurrentSince Jan 30, 2023 Accepting new patients
The Polyclinic PLLC CurrentSince Jan 25, 2023 Accepting new patients
Optum Care Washington PLLC CurrentSince Jan 30, 2023 Accepting new patients
Bellegrove OB/GYN, Inc. PS PastSince Aug 1, 2021 Accepting new patients
Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky Past Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
The Polyclinic PLLC Past Accepting new patients
Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky Past Accepting new patients
Overlake Medical Clinics, LLC PastSince Aug 1, 2021 Accepting new patients

Locations

1200 112th Ave NE
Ste C115
Bellevue, WA 98004
Phone (425) 455-0244

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

900 Pacific Ave
Everett, WA 98201
Phone (425) 258-7900

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1145 Broadway
Seattle, WA 98122

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

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

Interoperability endpoints

  • Direct secure messaging: agannon70517@direct.tecmc.com

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1649945940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PACIFIC AVE FL 5",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014168",
            "telephone_number": "425-339-5430",
            "fax_number": "425-339-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "ANIKA",
        "middle_name": "COLE",
        "credential": "CNM, DNP, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "WA",
            "license": "RN60867666",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61169082",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP61169082",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.