Individual provider Active NPI

Emily Chao Wong, NP-C

  • Nurse Practitioner
  • Everett, WA
National Provider Identifier
1861820425
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60776220 Issued in WA
Practice address
4201 Rucker Ave
Everett, WA 98203-2215
Phone
(425) 382-4000
NPI assigned
Oct 17, 2013
Last updated
Aug 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60776220 WA Primary
Naturopath 175F00000X NT60402553 WA

Addresses

Primary practice location

4201 Rucker Ave
Everett, WA 98203-2215

Mailing address

200 Oceangate Ste 100
Long Beach, CA 90802-4317
Phone (562) 435-3666

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180312000026 WA Practitioner - Nurse Practitioner 9436410396 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NT60402553WAMDNaturopath
AP60776220WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Snohomish County CurrentSince Mar 1, 2021 Accepting new patients
Molina Healthcare of Washington, Inc CurrentSince Jan 2, 2018 Accepting new patients
Community Health Center of Snohomish County CurrentSince Mar 1, 2021 Accepting new patients
Molina Healthcare of Washington, Inc Current Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

1019 112th St SW
Everett, WA 98204
Phone (425) 551-6001

15 SW Everett Mall Way
Ste A
Everett, WA 98204
Phone (425) 348-6727

4201 Rucker Ave
Everett, WA 98203
Phone (425) 382-4000

8609 Evergreen Way
Everett, WA 98208
Phone (425) 551-6200

Interoperability endpoints

  • Direct secure messaging: emily.wong.1@32512.direct.athenahealth.com

Organizations & group practices 4

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": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1861820425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "562-435-3666",
            "fax_number": "562-276-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032215",
            "telephone_number": "425-382-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "EMILY",
        "middle_name": "CHAO",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-17",
        "last_updated": "2021-08-06",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60776220",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT60402553",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.