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OPTUM - MARYSVILLE PHARMACY
NPI 1023188109
Pharmacy in Marysville, WA

Active since November 08, 2006CLIA Certified · 3 labs
4420 76TH ST NE, MARYSVILLE, WA 98270(360) 651-7410(360) 651-7415 Get Directions Write a Review

NPPES record last updated: April 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 8, 2024, Aug 22, 2020 (2 updates tracked since 2020).

About Optum - Marysville Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OPTUM - MARYSVILLE PHARMACY (NPI 1023188109) is a healthcare organization registered as a pharmacy in Marysville, Washington and active in the NPI registry since November 2006. The organization holds 3 active CLIA laboratory certificates and lists Kari Stanislaw, Senior Director, Pharmacy, as its authorized official.

NPPES Registry Identity

NPI1023188109
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameOPTUM CARE WASHINGTON PLLC
Location Address4420 76TH ST NEMarysville, WA 98270-3726
Mailing AddressPo Box 2747Everett, WA 98213-0747
Phone(360) 651-7410
Fax(360) 651-7415
Organization SubpartYes
Authorized OfficialKari StanislawSenior Director, Pharmacy · (425) 259-0966
Enumeration DateNovember 8, 2006
Last NPPES UpdateApril 8, 20242 updates tracked since enumeration
NPPES CertifiedApril 8, 2024
✔ NPI 1023188109 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in WA · CF00056585
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedPharmacy · Clinic PharmacyTaxonomy 3336C0002X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
4420 76TH ST NE, Marysville, WA 98270
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Other Names 1

Other NameOptum - Marysville Pharmacy

Other Identifiers 2

Medicaid6023147WA
Other4927969Other Id Number-commercial Number

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 50D0662653

Optum Care Washington, PLLC · Marysville, WA
Active · expires Apr 4, 2028
CLIA Number50D0662653
Laboratory TypePhysician Office
Certificate Effective DateNovember 1, 1993
Certificate Expiration DateApril 4, 2028
Laboratory DirectorJessica Estepp
Laboratory Phone(425) 317-3460
Laboratory LocationOptum Care Washington, PLLC4420 76th St NE, Marysville, WA 98270
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 50D2278946

Optum Care Washington, PLLC · Arlington, WA
Active · expires Apr 4, 2028
CLIA Number50D2278946
Laboratory TypePhysician Office
Certificate Effective DateApril 21, 2023
Certificate Expiration DateApril 4, 2028
Laboratory DirectorChristine A. Clark
Laboratory Phone(425) 259-0966
Laboratory LocationOptum Care Washington, PLLC4011 172nd St NE, Arlington, WA 98223
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 50D0662652

Optum Care Washington, PLLC · Marysville, WA
Active · expires Apr 4, 2028
CLIA Number50D0662652
Laboratory TypePhysician Office
Certificate Effective DateNovember 1, 1993
Certificate Expiration DateApril 4, 2028
Laboratory DirectorJessica Estepp
Laboratory Phone(425) 317-3460
Laboratory LocationOptum Care Washington, PLLC8923 Soper Hill Rd, Marysville, WA 98270
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SI JUNG SUH
Internal Medicine
4420 76TH ST NE
MARYSVILLE, WA 98270
Snohomish County (360) 651-7495
DOROTHY COLLEEN TODD ARNP
Nurse Practitioner
4420 76TH ST NE
MARYSVILLE, WA 98270
Snohomish County (360) 304-8489
MANUEL ENRIQUE SIERRA ASCENCIO
Internal Medicine
4420 76TH ST NE
MARYSVILLE, WA 98270
Snohomish County (360) 651-7491
CAMERYN ELIZABETH-ANNE GRASSANOVITS PA-C
Physician Assistant
4420 76TH ST NE
MARYSVILLE, WA 98270
Snohomish County (360) 651-7495
CHRISTOPHER M BEARD MD
Family Medicine
4420 76TH ST NE
MARYSVILLE, WA 98270
Snohomish County (360) 651-7495
MARY RECKARD ARNP
Nurse Practitioner
4420 76TH ST NE
MARYSVILLE, WA 98270
Snohomish County (360) 651-7406
TRACY BRIGMAN ARNP
Nurse Practitioner (Pediatrics)
4420 76TH ST NE
MARYSVILLE, WA 98270
Snohomish County (206) 860-4700
MS. DIANE L CASHMAN ARNP
Nurse Practitioner (Family)
4420 76TH ST NE
MARYSVILLE, WA 98270
Snohomish County (360) 651-7490

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Optum Care Washington PLLC's NPI number?

The NPI number for Optum Care Washington PLLC is 1023188109. It was assigned to this organization in the NPPES registry on November 8, 2006. The provider is also known as Optum - Marysville Pharmacy.

Where is Optum Care Washington PLLC located?

Optum Care Washington PLLC is located at 4420 76th St NE, Marysville, WA 98270. The listed phone number is (360) 651-7410.

What is Optum Care Washington PLLC's specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Optum Care Washington PLLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Optum Care Washington PLLC was last updated on April 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.