Individual provider Active NPI

Connie S Wang, M.D.

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1831383447
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60101017 Issued in WA
Practice address
904 7TH Ave
Seattle, WA 98104-1132
Phone
(206) 329-1760
NPI assigned
Aug 28, 2007
Last updated
May 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A94867 CA
Pediatrics Physician 208000000X MD60101017 WA Primary

Addresses

Primary practice location

904 7TH Ave
Seattle, WA 98104-1132

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

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
I20091022000749 WA Practitioner - Pediatric Medicine 1355437153 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Pediatrics Current Accepting new patients
Optum Care Washington PLLC Pediatrics CurrentSince Jun 7, 2025 Accepting new patients
Optum Care Washington PLLC Pediatrics CurrentSince Jun 7, 2025 Accepting new patients
The Polyclinic PLLC CurrentSince Jan 1, 2014 Accepting new patients
Swedish Health Services Past Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903

1145 Broadway
Seattle, WA 98122

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900

Interoperability endpoints

  • Direct secure messaging: cwang1068401@wm.providencedirect.org
  • Direct secure messaging: cwang21190@direct.tecmc.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1831383447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 7TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041132",
            "telephone_number": "206-329-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "CONNIE",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A94867",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60101017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.