THE EVERETT CLINIC, PLLC (NPI# 1144837345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144837345 |
| Entity Type | Organization |
| Organization Name | THE EVERETT CLINIC, PLLC |
| Practice Address |
11019 Canyon Rd E Ste A Puyallup WA 98373-3001 |
| Mailing Address |
Po Box 5127 Everett WA 98206-5127 |
| Practice Telephone | 2535370293 |
| Practice Fax Number | 2535377650 |
| Mailing Telephone | 2535370293 |
| Mailing Fax Number | 2535377650 |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2020-09-30 |
| Authorized Official Name | SHAWN SLACK (BOARD PRESIDENT) |
| Authorized Official Telephone | 4253395445 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Summit View Clinic, part of The Everett Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255950572 | The Everett Clinic, Pllc | Family Medicine | 528 Myrtle Street, Laconner, WA 98257 | 2020-04-16 |
| 1770006330 | The Everett Clinic, Pllc | Clinical Medical Laboratory | 18505 Bothell Way Ne Ste 215, Bothell, WA 98011-3717 | 2017-07-25 |
| 1861928830 | The Everett Clinic, Pllc | Clinical Medical Laboratory | 17000 140th Ave Ne Unit 101, Woodinville, WA 98072-6928 | 2017-05-11 |
| 1598205908 | The Everett Clinic, Pllc | Family Medicine | 11800 Ne 128th St Ste 560, Kirkland, WA 98034-7208 | 2017-03-03 |
| 1619575933 | The Everett Clinic, Pllc | Non-Pharmacy Dispensing Site | 1717 13th St, Everett, WA 98201-1621 | 2020-10-09 |
| 1629698964 | The Everett Clinic, Pllc | Family Medicine | 912 32nd St Ste A, Anacortes, WA 98221-3473 | 2020-04-16 |
| 1689144388 | The Everett Clinic, Pllc | Family Medicine | 1200 112th Ave Ne Ste C160, Bellevue, WA 98004-3742 | 2018-11-26 |
| 1275074544 | The Everett Clinic, Pllc | Durable Medical Equipment & Medical Supplies | 21401 72nd Ave W, Edmonds, WA 98026-7702 | 2017-03-20 |
| 1164972527 | The Everett Clinic, Pllc | Internal Medicine | 3916 148th St Se, Mill Creek, WA 98012-4751 | 2016-10-10 |
| 1467907287 | The Everett Clinic, Pllc | Durable Medical Equipment & Medical Supplies | 21401 72nd Ave W, Edmonds, WA 98026-7702 | 2016-08-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | THE EVERETT CLINIC, PLLC | 3901 Hoyt Ave, Everett, WA 98201-4918 |
| Street Address |
11019 CANYON RD E STE A |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98373-3001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497718316 | Courtney Anne Albert | Nurse Practitioner | 11019 Canyon Rd E Ste A, Puyallup, WA 98373-3001 | 2006-04-11 |
| 1063999753 | Taelin Lanier | Dietitian, Registered | 11019 Canyon Rd E Ste A, Puyallup, WA 98373-3001 | 2018-07-25 |
| 1447762000 | Lex Barker | Physician Assistant | 11019 Canyon Rd E Ste A, Puyallup, WA 98373 | 2017-11-03 |
| 1760917363 | Annalyse R Quintero | Family Medicine | 11019 Canyon Rd E Ste A, Puyallup, WA 98373-3001 | 2017-04-21 |
| 1710332259 | David Brent Mccaleb | Family Medicine | 11019 Canyon Rd E Ste A, Puyallup, WA 98373-3001 | 2016-05-03 |
| 1851761027 | Calvin Clarke | Nurse Practitioner | 11019 Canyon Rd E Ste A, Puyallup, WA 98373-3001 | 2015-10-01 |
| 1538456280 | John Dinh | Family Medicine | 11019 Canyon Rd E Ste A, Puyallup, WA 98373-3001 | 2011-07-01 |
| 1528210838 | Tracy D Brady | Family Medicine | 11019 Canyon Rd E Ste A, Puyallup, WA 98373-3001 | 2008-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494711 | Caroline Brown Corbett | Dentist | 8012 112th St Ct E #320, Puyallup, WA 98373 | 2020-10-13 |
| 1629615760 | Jessie Jean Waiamau-ariota | Counselor | Winds of Liberty, 702 S Hill Park Dr Ste 206, Puyallup, WA 98373 | 2019-12-09 |
| 1194369181 | Ruba H Tawil | Dentist | 12005 Meridian E # 102, Puyallup, WA 98373 | 2019-11-01 |
| 1336621267 | Cara Tseng | Physician Assistant | 2940 S Meridian, Suite 200, Puyallup, WA 98373 | 2018-09-06 |
| 1902390289 | Melissa M Jenkins | Registered Nurse | 2920 S Meridian Ste 100, Puyallup, WA 98373 | 2018-06-19 |
| 1881141323 | Linda Cole | Massage Therapist | 8409 204th Street East, Spanaway, WA 98373 | 2016-09-01 |
| 1861855389 | Christina Leigh Bailey | Optometrist | 3500 S Meridian Ste 926, Puyallup, WA 98373 | 2016-04-01 |
| 1518301951 | Bryan Michael Swanson | Dentist | 2910 S Meridian Ste 120, Puyallup, WA 98373 | 2013-04-27 |
| 1760720569 | Vankosin Hewitt | Massage Therapist | 13613 Meridian East # 260, Puyallup, WA 98373 | 2013-01-29 |
| 1558607705 | Rosie Martinez | Counselor | 12812 101st Avenue Courte E, Suite 202, Puyallup, WA 98373 | 2012-12-17 |
| Find all providers in zip 98373 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225584683 | Paladina Health, LLC | Family Medicine | 615 E Pioneer, Suite 103, Puyallup, WA 98372-3317 | 2016-08-26 |
| 1588048862 | Chelsi Goodman | Family Medicine | 1322 3rd St Se Ste 300, Puyallup, WA 98372 | 2015-07-16 |
| 1366824914 | Cris Perez | Family Medicine | 1322 3rd St Se Ste 302, Puyallup, WA 98372-3771 | 2015-06-19 |
| 1891042958 | Noor Azreen Ali | Family Medicine | 15214 Canyon Rd E Ste 100, Puyallup, WA 98375-7472 | 2012-08-08 |
| 1265655070 | Douglas Allan Badzik | Family Medicine | 8919 119th Street Ct E, Puyallup, WA 98373-7976 | 2007-04-10 |
| 1912055286 | Sea-mar Community Health Center | Family Medicine | 10217 125th Street Ct E Fl 2, Puyallup, WA 98374-2761 | 2007-01-05 |
| 1083788160 | John N Daniel | Family Medicine | 801 E Main Street, Puyallup, WA 98372-3365 | 2006-11-20 |
| 1053403634 | Mark S. Kim | Family Medicine | 1803 S Meridian, Puyallup, WA 98371 | 2006-09-29 |
| 1518079722 | Bruce K. Baker | Family Medicine | 1408 3rd St Se Ste 200, Puyallup, WA 98372 | 2006-09-01 |
| 1508881228 | Linh Trang Huynh | Family Medicine | 10116 116th St E, Suite 101, Puyallup, WA 98373-3543 | 2006-07-13 |
| Find all providers in PUYALLUP | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.