Active NPI
Andrew Michael Owen, D.O.
- Psychiatry Physician
- Port Orchard, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 60749940
- Practice address
- 1400 Pottery Ave
Port Orchard, WA 98366-3711 - Phone
- (360) 895-5000
- Fax
- (877) 516-9023
- NPI assigned
- Apr 26, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | |||
| Psychiatry Physician | 2084P0800X | 60749940 | WA | Primary |
Addresses
Primary practice location
1400 Pottery Ave
Port Orchard, WA 98366-3711
Mailing address
1 Boone Rd
Bremerton, WA 98312-1898
Phone (360) 475-4219
Other practice location 1
34800 Bob Wilson Dr
San Diego, CA 92134-1108
Phone (619) 532-8555
Other practice location 2
1 Boone Rd
Bremerton, WA 98312-1894
Phone (360) 475-4219
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1400 Pottery Ave
Port Orchard, WA 98366-3711
Phone (360) 895-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60749940 | WA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Front Street Clinic Inc | Past | Accepting new patients |
Locations
1400 Pottery Ave
Port Orchard, WA 98366
Phone (360) 895-5000
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Interoperability endpoints
- aowen4442724@ghc.direct-ci.net
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
-
- Psychologist
- Poulsbo, WA
- NPI 1457532913
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728604800000",
"number": "1689029720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 BOONE RD",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983121898",
"telephone_number": "360-475-4219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 POTTERY AVE",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983663711",
"telephone_number": "360-895-5000",
"fax_number": "877-516-9023"
}
],
"practiceLocations": [
{
"address_1": "34800 Bob Wilson Dr",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921341108",
"country_code": "US",
"telephone_number": "619-532-8555",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Boone Rd",
"address_purpose": "LOCATION",
"city": "Bremerton",
"state": "WA",
"postal_code": "983121894",
"country_code": "US",
"telephone_number": "360-475-4219",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OWEN",
"first_name": "ANDREW",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-26",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "60749940",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1400 Pottery Ave",
"city": "Port Orchard",
"state": "WA",
"country_code": "US",
"postal_code": "983663711",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Port Orchard, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.