Delta Medical Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DELTA MEDICAL CLINIC LLC

Practice address

4215 198TH St SW Ste 102
Lynnwood, WA 98036-6738

Phone

(425) 725-9659

NPI assigned

Feb 1, 2023

Organization subpart

No

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

Authorized official

Name

Uyen N NguyenNPI 1699432666

Title

Practitioner

Phone

(206) 794-2015

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

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

• Uyen N Nguyen, ARNP, DNP

  • Nurse Practitioner
  • Lynnwood, WA
  • NPI 1699432666
  Medicare reassignment NPD Authorized official
• Jeanne M Isaacson, MD

  • Internal Medicine Physician
  • Burien, WA
  • NPI 1093707929
  NPD (past)

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1992401897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17806 5TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981553513",
            "telephone_number": "206-794-9948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 198TH ST SW STE 102",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366738",
            "telephone_number": "425-725-9659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17806 5th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Shoreline",
            "state": "WA",
            "postal_code": "981553513",
            "country_code": "US",
            "telephone_number": "206-794-9948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14463 Military Rd S",
            "address_purpose": "LOCATION",
            "city": "Tukwila",
            "state": "WA",
            "postal_code": "981684255",
            "country_code": "US",
            "telephone_number": "425-725-9659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DELTA MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-01",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "UYEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "206-794-2015"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Defuria, L.M.P.
• Jessica Degamo
• Michael Andrew Degroot, MD
• Daniel Dejenie, RN60804372
• Stephanie Delos Santos, R. PH.
• Ryna Demarse, RN
• Liang-Yu Deng
• Christy Denova
• Ryan Derienzo
• Laura Maria Dermer

• Clinic/Center in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.