Individual provider Active NPI

Kjersten Gmeiner, M.D.

  • Family Medicine Physician
  • Everett, WA
National Provider Identifier
1922151612
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00039154 Issued in WA
Practice address
3927 Rucker Ave
Everett, WA 98201-4833
Phone
(206) 860-5414
NPI assigned
Jan 18, 2007
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00039154 WA Primary
Family Medicine Physician 207Q00000X C53440 CA

Addresses

Primary practice location

3927 Rucker Ave
Everett, WA 98201-4833

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
332441OtherWASTATE L&I
8275638MedicaidWA

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
I20140610002119 WA Practitioner - Family Practice 7113088725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

1201 N 175TH St
Shoreline, WA 98133-5064
Phone (425) 339-4299

1330 Rockefeller Ave
Everett, WA 98201-1684
Phone (425) 259-0966

1818 121St St SE
Everett, WA 98208-5985
Phone (425) 357-3300

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442

3927 Rucker Ave
Everett, WA 98201-4833
Phone (425) 259-0966

4410 106TH St SW
Mukilteo, WA 98275-4700
Phone (425) 493-6000

4420 76TH St NE
Marysville, WA 98270-3726
Phone (360) 651-7490

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC Family Medicine CurrentSince Nov 16, 2015 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Nov 16, 2015 Accepting new patients
Fremont Family Practice LLC Family Medicine CurrentSince Oct 13, 2015 Accepting new patients
Eric Dunlop, DO, Inc. Family Medicine Past Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
Franciscan Medical Group Past Accepting new patients
Central Rehabilitation Clinic Inc PastSince Mar 14, 2010 Accepting new patients

Locations

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

3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419

3927 Rucker Ave
Ste 202
Everett, WA 98201

4464 Fremont Ave N
Ste 103
Seattle, WA 98103
Phone (206) 267-7300

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

Interoperability endpoints

  • Direct secure messaging: kgmeiner14737@direct.tecmc.com

Organizations & group practices 7

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1922151612",
    "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": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "206-860-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GMEINER",
        "first_name": "KJERSTEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00039154",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C53440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "332441",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8275638",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.