Principal Health Clinic LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

PRINCIPAL HEALTH CLINIC LLC

Practice address

21525 Sr 410 E Ste a
Bonney Lake, WA 98391-4101

Phone

(253) 499-6999

Fax

(888) 440-5188

NPI assigned

Jan 14, 2025

Last updated

Aug 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bien NguyenNPI 1982180683

Title

Mr.

Phone

(253) 499-6999

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bien Nguyen, NP-C

  • Family Nurse Practitioner
  • Bonney Lake, WA
  • NPI 1982180683

  Addiction Medicine

  Medicare reassignment NPD Authorized official
• Faduma Abdirahman Haji Ali, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bellevue, WA
  • NPI 1073071437
  Medicare reassignment NPD
• Duy Trinh, NP

  • Family Nurse Practitioner
  • Bonney Lake, WA
  • NPI 1396299616
  Medicare reassignment NPD
• Irene Mutua, FNP-C

  • Family Medicine Physician
  • Lakewood, WA
  • NPI 1811795792
  Medicare reassignment
• Roger M Blauvelt, MD

  • Specialist
  • Auburn, WA
  • NPI 1932187341
  NPD
• J. Chriss Cancro, MD

  • Specialist
  • Auburn, WA
  • NPI 1245218668
  NPD
• Robert E. Carlson, MD

  • Specialist
  • Auburn, WA
  • NPI 1487632683
  NPD
• Sisay Faynato

  • Psychiatric/Mental Health Nurse Practitioner
  • Lynnwood, WA
  • NPI 1679303564
  NPD
• Hisashi Wesley Kobayashi, MD

  • Physical Medicine & Rehabilitation Physician
  • Issaquah, WA
  • NPI 1689820227
  NPD
• Susie Suhyun Kwon

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Kirkland, WA
  • NPI 1578958971
  NPD
• Richard Paul Martin, MD

  • Orthopaedic Surgery Physician
  • Enumclaw, WA
  • NPI 1871546671
  NPD
• Maryanne Wambui Mirie, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Puyallup, WA
  • NPI 1407405657
  NPD

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1932910684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7531",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983910924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21525 SR 410 E STE A",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983914101",
            "telephone_number": "253-499-6999",
            "fax_number": "888-440-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCIPAL HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "BIEN",
        "authorized_official_title_or_position": "MR.",
        "authorized_official_telephone_number": "253-499-6999"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Arthur Pomerenke
• Emily R Potter, R.PH.
• Heather Lynn Prescott, LICSW
• Janessa Pallasigui Pressley, PHARM D
• Prestige Mental Health
• Proliance Surgeons Inc P S (Proliance Rainier Orthopedic Institute)
• Puget Sound Specialty Physicians PLLC (Ankle & Foot Specialist of Bonney Lake)
• Annie Quach, RPH
• Rainier Biobehavioral Institute, LLC (Rbi)
• Rainier Biobehavioral Institute, LLC (Rbi)

• Primary Care Nurse Practitioner in Bonney Lake, WA
• Providers in Bonney Lake, WA by specialty
• Primary Care Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.