MR. ETIENNE CLEMENT POUFONG NP
NPI 1023626959
Nurse Practitioner - Psychiatric/Mental Health in Mountlake Terrace, WA

Q: What is Etienne Poufong's NPI number?

The NPI number for Etienne Poufong is 1023626959. It was assigned to this individual provider in the NPPES registry on July 16, 2020.

Q: What is Etienne Poufong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Etienne Poufong was last updated on June 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 16, 2020PECOS EnrolledAccepts Medicare Assignment

1001 - MOUNTLAKE TERRACE, MOUNTLAKE TERRACE, WA 98043(469) 321-9543 Get Directions Write a Review

NPPES record last updated: June 25, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 25, 2023, Apr 6, 2023, Jul 16, 2020 (3 updates tracked since 2020).

On this page

About Mr. Etienne Clement Poufong Np NPPES

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

MR. ETIENNE CLEMENT POUFONG NP (NPI 1023626959) is an individual psychiatric/mental health provider in Mountlake Terrace, Washington, licensed in Washington (AP61426687) and active in the NPI registry since July 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1023626959

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameMR. ETIENNE CLEMENT POUFONGCredential: NP

Location Address1001 - MOUNTLAKE TERRACEMountlake Terrace, WA 98043-7510

Mailing Address708 Clement DrCedar Hill, TX 75104-7352 · (469) 321-9543 · Fax (817) 471-3269

Phone(469) 321-9543

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateJuly 16, 2020

Last NPPES UpdateJune 25, 20233 updates tracked since enumeration

NPPES CertifiedJune 25, 2023

✔ NPI 1023626959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

Licenses✔ Licensed in WA · AP61426687✔ Licensed in TX · AP146155

1001 - MOUNTLAKE TERRACE, Mountlake Terrace, WA 98043

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Providence Health Plan, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Etienne Clement Poufong Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173923166

PECOS Enrollment IDI20210614000427, I20231109001711

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98043 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Etienne Poufong's NPI number?

The NPI number for Etienne Poufong is 1023626959. It was assigned to this individual provider in the NPPES registry on July 16, 2020.

Where is Etienne Poufong located?

Etienne Poufong practices at 1001 - Mountlake Terrace, Mountlake Terrace, WA 98043. The listed phone number is (469) 321-9543.

What is Etienne Poufong's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Etienne Poufong enrolled in Medicare?

Yes. Etienne Poufong is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Etienne Poufong accept?

Health plans from Blue Cross and Blue Shield of Texas, Providence Health Plan and UnitedHealthcare list Etienne Poufong as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Etienne Poufong was last updated on June 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.