Individual provider Active NPI

Daniel Minwoo Pak, MD

  • Family Medicine Physician
  • Arlington, WA
National Provider Identifier
1780250993
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61546191 Issued in WA
Practice address
3823 172ND St NE
Arlington, WA 98223-7325
Phone
(360) 657-8840
NPI assigned
May 28, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61546191 WA Primary

Addresses

Primary practice location

3823 172ND St NE
Arlington, WA 98223-7325

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Other identifiers 1

IdentifierTypeStateIssuer
2297721MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dpak80468@skagit.direct-ci.com Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240919003694 WA Practitioner - Family Practice 8325441454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, shared by 7 NPIs, 321 clinicians

Practice addresses (Care Compare)

12800 Bothell Everett Hwy
Everett, WA 98208-6644

3823 172ND St NE
Arlington, WA 98223-7735
Phone (360) 651-8365

4112 Harbour Pointe Blvd SW
Suite 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD61546191WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Sep 1, 2024 Accepting new patients
Providence Health & Services-Washington CurrentSince Sep 1, 2024 Accepting new patients
Providence Health & Services - Washington Family Medicine Past Accepting new patients

Locations

12800 Bothell Everett Hwy
Everett, WA 98208
Phone (425) 316-5060

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

12800 Bothell Everett Hwy
Ste 160
Everett, WA 98208
Phone (425) 316-5170

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1780250993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3823 172ND ST NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237325",
            "telephone_number": "360-657-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "DANIEL",
        "middle_name": "MINWOO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-28",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61546191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2297721",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpak80468@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3823 172nd St NE",
            "city": "Arlington",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982237325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

Verify at the official NPI Registry.