PROVIDENCE HEALTH & SERVICES - WASHINGTON
NPI 1063663458
Family Medicine in Marysville, WA
NPI Status: Active since October 04, 2008
Contact Information
11603 STATE AVE
SUITE G
MARYSVILLE, WA
ZIP 98271
Phone: (360) 658-6800
Fax: (360) 658-6819
- Organization
- Family Medicine
- Accepts Insurance
- CLIA Number: 50D0716767
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-04-2028
About PROVIDENCE HEALTH & SERVICES - WASHINGTON
This page provides the complete NPI Profile along with additional information for Providence Health & Services - Washington, a primary care provider established in Marysville, Washington operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1063663458 assigned on October 2008. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated one year ago. Providence Health & Services - Washington operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's
- NPI
- 1063663458
- Provider Legal Name
- PROVIDENCE HEALTH & SERVICES - WASHINGTON
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 11603 STATE AVE SUITE G MARYSVILLE, WA 98271
- Location Phone
- (360) 658-6800
- Location Fax
- (360) 658-6819
- Mailing Address
- PO BOX 31001-4114 PASADENA, CA 91110
- Mailing Phone
- (425) 358-9786
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-04-2008
- Last Update Date
- 05-12-2025
- Code Navigator
A primary care provider (PCP) like Providence Health & Services - Washington sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 2 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | |
| 3 | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | |
| 4 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
- Premera Blue Cross Family Dental - PPO
- Premera Blue Cross Pediatric Dental - PPO
- HSA-E Qualified 7500 Bronze - Signature Network - EPO
- Providence Oregon Standard Bronze Plan - Signature Network - EPO
- Providence Oregon Standard Gold Plan - Signature Network - EPO
- Providence Oregon Standard Silver Plan - Signature Network - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 50D0716767
- Facility Type
- Physician Office
- Certificate Effective Date
- April 03, 2025
- Certificate Expiration Date
- April 04, 2028
- Laboratory Director
- JENNIFER ENGSTROM
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Providence Health & Services - Washington to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1063663458, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063663458, enumerated as an "organization" on October 04, 2008.
The provider is located at 11603 STATE AVE SUITE G MARYSVILLE, WA 98271 and the phone number is (360) 658-6800.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska and. Please consult your insurance carrier or call the provider to verify.
