THE EVERETT CLINIC, PLLC (NPI# 1598205908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598205908 |
| Entity Type | Organization |
| Organization Name | THE EVERETT CLINIC, PLLC |
| Practice Address |
11800 Ne 128th St Ste 560 Kirkland WA 98034-7208 |
| Mailing Address |
Po Box 5127 Everett WA 98206-5127 |
| Practice Telephone | 4258995200 |
| Practice Fax Number | 4258995204 |
| Mailing Telephone | 4253048431 |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2018-03-28 |
| Authorized Official Name | ANDREA RODEWALD (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4253395460 |
| Is Organization Subpart | Y |
| Parent Organization Name | DAVITA EVERETT PHYSICIANS, INC. P.S. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 291U00000X | Clinical Medical Laboratory | 50D0704127 | WA | Laboratories |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| 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 |
| 1619575933 | The Everett Clinic, Pllc | Non-Pharmacy Dispensing Site | 1717 13th St, Everett, WA 98201-1621 | 2020-10-09 |
| 1144837345 | The Everett Clinic, Pllc | Clinical Medical Laboratory | 11019 Canyon Rd E Ste A, Puyallup, WA 98373-3001 | 2020-09-30 |
| 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 |
11800 NE 128TH ST STE 560 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-7208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376158725 | Wound Pros Washington | Durable Medical Equipment & Medical Supplies | 11335 Ne 122nd, Suite 105, Kirkland, WA 98034-6933 | 2020-09-12 |
| 1518506815 | Kestra Medical Techonology Services, Inc. | Durable Medical Equipment & Medical Supplies | 3933 Lake Washington Blvd Ne Ste 200, Kirkland, WA 98033-7806 | 2020-01-03 |
| 1033756986 | Totem Lake Physical Therapy, Pllc | Durable Medical Equipment & Medical Supplies | 12910 Totem Lake Blvd Ne Ste 130, Kirkland, WA 98034-2955 | 2019-12-10 |
| 1285270587 | Totem Lake Physical Therapy, Pllc | Durable Medical Equipment & Medical Supplies | 12707 120th Ave Ne Ste 203, Kirkland, WA 98034-7500 | 2019-11-21 |
| 1851855142 | Northup Group LLC. | Durable Medical Equipment & Medical Supplies | 11003 118th Pl Ne, Kirkland, WA 98033-5053 | 2019-01-30 |
| 1740382597 | Md-direct | Durable Medical Equipment & Medical Supplies | 221 10th Ave, Kirkland, WA 98033-5521 | 2006-09-02 |
| 1619088515 | Hanger Prosthetics & Orthotics West Inc | Durable Medical Equipment & Medical Supplies | 12039 Ne 128th St Ste 140, Kirkland, WA 98034-3036 | 2006-08-31 |
| 1972612299 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 12421 Totem Lake Boulevard Northeast, Kirkland, WA 98034-7504 | 2006-08-30 |
| 1003821083 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 11607 98th Ave Ne, Kirkland, WA 98034-4216 | 2006-07-29 |
| 1942214903 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 9820 Northeast 132nd Street, Kirkland, WA 98034-1927 | 2006-07-27 |
| Find all providers in KIRKLAND | ||||
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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.