Individual provider Active NPI

Joanne Chung, PA

  • Physician Assistant
  • Mukilteo, WA
National Provider Identifier
1942055215
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61625423 Issued in WA
Practice address
4410 106TH St SW
Mukilteo, WA 98275-4700
Phone
(425) 259-0966
NPI assigned
Apr 20, 2024
Reactivated
Nov 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61625423 WA Primary

Addresses

Primary practice location

4410 106TH St SW
Mukilteo, WA 98275-4700

Mailing address

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

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
I20250218001742 WA Practitioner - Physician Assistant 3870013154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

11800 NE 128TH St
Suite 560
Kirkland, WA 98034-7208
Phone (425) 899-5200

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

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

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

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Internal Medicine CurrentSince Jan 13, 2025 Accepting new patients
The Polyclinic PLLC Internal Medicine CurrentSince Jan 13, 2025 Accepting new patients
Optum Care Washington PLLC Internal Medicine CurrentSince Jan 13, 2025 Accepting new patients
Optum Care Washington PLLC Internal Medicine CurrentSince Jan 13, 2025 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

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

4410 106th St SW
Mukilteo, WA 98275
Phone (206) 388-6000

1145 Broadway
Seattle, WA 98122

9709 3rd Ave NE
Fl 2
Seattle, WA 98115
Phone (206) 525-5777

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

Interoperability endpoints

  • Direct secure messaging: jchung93904@direct.tecmc.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1713571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1942055215",
    "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": "4410 106TH ST SW",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982754700",
            "telephone_number": "425-259-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "JOANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-20",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "deactivation_date": "2024-10-29",
        "reactivation_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61625423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

Verify at the official NPI Registry.