NPIMap

Organization Active NPI

Northwest Kidney Centers

Doing business as Enumclaw Kidney Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Enumclaw, WA
National Provider Identifier
1811241656
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
NORTHWEST KIDNEY CENTERS
Doing business as
Enumclaw Kidney Center
NKC Enumclaw Kidney Center
Practice address
857 Roosevelt Ave E
Enumclaw, WA 98022-9239
Phone
(360) 825-2050
NPI assigned
Nov 1, 2012
Last updated
Apr 4, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWEST KIDNEY CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Authorized official

Name
Jennifer Eslava
Title
Chief Financial Officer
Phone
(206) 292-2771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X WA Primary

Addresses

Primary practice location

857 Roosevelt Ave E
Enumclaw, WA 98022-9239

Mailing address

12901 20TH Ave S
Seatac, WA 98168-5159
Phone (206) 292-2771

Other identifiers 1

IdentifierTypeStateIssuer
2029785MedicaidWA

Other names 2

  • Enumclaw Kidney Center Doing business as
  • NKC Enumclaw Kidney Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121227000470 WA Part A Provider - End-Stage Renal Disease Facility (ESRD) 5799673679 Practice locations: Enumclaw, WA

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
NKC Enumclaw Kidney CenterCCN 502570
Overall star rating
4.0 of 5
Ownership
Non-profit
Certified
Mar 4, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Northwest Kidney Centers
Dialysis stations
10

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
NW Kidney Center Physician21 organizations share this tax ID, including this one
Part of
NW Kidney Center Physician

Other organizations with this tax ID 20

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

View all 20

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743724800000",
    "number": "1811241656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12901 20TH AVE S",
            "city": "SEATAC",
            "state": "WA",
            "postal_code": "981685159",
            "telephone_number": "206-292-2771",
            "fax_number": "206-860-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 ROOSEVELT AVE E",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980229239",
            "telephone_number": "360-825-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST KIDNEY CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST KIDNEY CENTERS",
        "enumeration_date": "2012-11-01",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A",
        "authorized_official_last_name": "ESLAVA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "206-292-2771"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029785",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enumclaw Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NKC Enumclaw Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enumclaw, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.