NPIMap

Organization Active NPI

Northwest Kidney Centers

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Port Angeles, WA
National Provider Identifier
1891880332
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
Practice address
707 S Chase St
Port Angeles, WA 98362-6121
Phone
(206) 292-2771
Fax
(206) 860-5821
NPI assigned
Oct 3, 2006
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 Primary

Addresses

Primary practice location

707 S Chase St
Port Angeles, WA 98362-6121

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
0251OtherWAREGENCE BLUE SHIELD
179OtherWAPREMERA BLUE CROSS
1046099MedicaidWA

Other names 3

  • NKC Port Angeles Kidney Center Doing business as
  • Northwest Kidney Centers dba Port Angeles Kidney Center Doing business as
  • Port Angeles 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
O20090708000743 WA Part A Provider - End-Stage Renal Disease Facility (ESRD) 5799673679 Practice locations: Port Angeles, 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 Port Angeles Kidney CenterCCN 502510
Overall star rating
3.0 of 5
Ownership
Non-profit
Certified
Jul 18, 1988
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
Northwest Kidney Centers21 organizations share this tax ID, including this one
Part of
Northwest Kidney Centers

Other organizations with this tax ID 20

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

View all 20

Locations

809 Georgiana St
Port Angeles, WA 98362
Phone (360) 504-3784

707 S Chase St
Port Angeles, WA 98362
Phone (360) 565-1435

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743724800000",
    "number": "1891880332",
    "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": "707 S CHASE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983626121",
            "telephone_number": "206-292-2771",
            "fax_number": "206-860-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST KIDNEY CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST KIDNEY CENTERS",
        "enumeration_date": "2006-10-03",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "0251",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "179",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1046099",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NKC Port Angeles Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northwest Kidney Centers dba Port Angeles Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Port Angeles Kidney Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Angeles, 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.