Individual provider Active NPI

Shirley Nie

  • Family Nurse Practitioner
  • Everett, WA
National Provider Identifier
1679463434
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP.AP.70024845-NP Issued in WA
Practice address
3927 Rucker Ave
Everett, WA 98201-4833
Phone
(425) 259-0966
NPI assigned
Jul 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP.AP.70024845-NP WA Primary
Registered Nurse 163W00000X RN61284654 WA

Addresses

Primary practice location

3927 Rucker Ave
Everett, WA 98201-4833

Mailing address

PO Box 5127
Everett, WA 98206-5127

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
I20250813001922 WA Practitioner - Nurse Practitioner 2769980234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

3927 Rucker Ave
Everett, WA 98201-4833
Phone (425) 259-0966

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN61284654WAMDRegistered Nurse
ARNP.AP.70024845-NPWAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Aug 25, 2025 Accepting new patients
The Polyclinic PLLC CurrentSince Aug 25, 2025 Accepting new patients
Optum Care Washington PLLC CurrentSince Aug 25, 2025 Accepting new patients
The Polyclinic CurrentSince Aug 25, 2025 Accepting new patients
The Polyclinic PLLC Current Accepting new patients
The Polyclinic PLLC Past Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419

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

1818 121st St SE
Everett, WA 98208
Phone (425) 304-1100

1145 Broadway
Seattle, WA 98122

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

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

  • FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4
  • Direct secure messaging: snie99760@direct.tecmc.com

Organizations & group practices 7

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": "1751500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1679463434",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-259-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIE",
        "first_name": "SHIRLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "ARNP.AP.70024845-NP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61284654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.