NPIMap

Optum Care Washington PLLC

Organization Active NPI Durable Medical Equipment & Medical Supplies · Stanwood, WA

NPI 1881746063 · NPPES record last updated Apr 11, 2024

Key facts

NPI
1881746063
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
OPTUM CARE WASHINGTON PLLC
Practice address
7205 265TH St NW
Stanwood, WA 98292-6221
Phone
(360) 629-1500
NPI assigned
Jan 17, 2007
Organization subpart
Yes
Parent organization (as reported)
EVERETT PHYSICIANS, INC. P.S.

Authorized official

Name
Dr. George Go, MD
Title
Board President
Phone
(425) 259-0966

Other NPIs with the same Medicare PAC ID 19

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

Corporate family (same tax ID) 29

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

View all 29

Practitioners 684

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 684

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0919596Optum Care Washington, PLLC
7205 265TH St NW, Stanwood, WA 98292		ComplianceApr 4, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930052469 WA DME Supplier - Multi-Specialty - Physician 6406752153 Practice locations: Stanwood, WA

National Provider Directory

Tax ID family
Everett Clinic (30 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

7205 265TH St NW
Stanwood, WA 98292-6221

Mailing address

PO Box 5127
Everett, WA 98206-5127

Other identifiers

IdentifierTypeStateIssuer
33000OtherWAL&I
7776503MedicaidWA

Other names

  • Optum - Stanwood Other name

Other providers in Stanwood, WA

All providers in Stanwood, WA · Durable Medical Equipment & Medical Supplies in Washington

Sources for this page

Verify at the official NPI Registry.