Individual provider Active NPI

Emery Van Broekhuizen, MSW, LSWAIC

  • Clinical Social Worker
  • Tacoma, WA
National Provider Identifier
1811710163
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SC61615248 Issued in WA
Practice address
4301 S Pine St
Tacoma, WA 98409-7264
Phone
(253) 476-6500
NPI assigned
Nov 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SC61615248 WA Primary

Addresses

Primary practice location

4301 S Pine St
Tacoma, WA 98409-7264

Mailing address

4301 S Pine St
Tacoma, WA 98409-7264
Phone (253) 476-6500

Electronic endpoints 1

TypeEndpointUseAffiliation
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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260306002403 WA Practitioner - Clinical Social Worker 1658853726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4301 S Pine St
Tacoma, WA 98409-7206

5615 W Sunset Hwy
Spokane, WA 99224-9454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC61615248WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Feb 1, 2026 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Feb 1, 2026 Accepting new patients

Locations

4301 S Pine St
Ste 301
Tacoma, WA 98409
Phone (253) 476-6500

Organizations & group practices 2

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": "1730764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1811710163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 S PINE ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097264",
            "telephone_number": "253-476-6500",
            "fax_number": "253-476-6547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 S PINE ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097264",
            "telephone_number": "253-476-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BROEKHUIZEN",
        "first_name": "EMERY",
        "name_prefix": "Mr.",
        "credential": "MSW, LSWAIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-05",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61615248",
            "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": "4301 S Pine St",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984097264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.