NPIMap

Organization Active NPI

Optum Care Washington PLLC

  • Community/Retail Pharmacy
  • Mill Creek, WA
National Provider Identifier
1699844936
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF58850 Issued in WA
Legal business name
OPTUM CARE WASHINGTON PLLC
Practice address
15418 Main St
Suite 106
Mill Creek, WA 98012
Phone
(425) 225-8010
Fax
(425) 225-8009
NPI assigned
Nov 8, 2006
Last updated
Apr 11, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
EVERETT PHYSICIANS, INC. P.S.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Authorized official

Name
Dr. George Go, MD
Title
Board President
Phone
(425) 259-0966

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X CF58850 WA Primary

Addresses

Primary practice location

15418 Main St
Suite 106
Mill Creek, WA 98012

Mailing address

PO Box 2747
Everett, WA 98213-0747

Other identifiers 1

IdentifierTypeStateIssuer
4932136OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • Optum - Mill Creek Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Everett Clinic30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

15418 Main St
Ste 106
Mill Creek, WA 98012
Phone (425) 225-8010

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1699844936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2747",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982130747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15418 MAIN ST",
            "address_2": "SUITE 106",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "98012",
            "telephone_number": "425-225-8010",
            "fax_number": "425-225-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM CARE WASHINGTON PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERETT PHYSICIANS, INC. P.S.",
        "enumeration_date": "2006-11-08",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "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_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF58850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4932136",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum - Mill Creek Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.