PROVIDENCE HEALTH & SERVICES - WASHINGTON
NPI 1124279237
Family Medicine in Mukilteo, WA

NPI Status: Active since October 07, 2008

Contact Information

4112 HARBOUR POINTE BLVD SW
SUITE 100
MUKILTEO, WA
ZIP 98275
Phone: (425) 347-6330
Fax: (425) 347-6335

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  • Organization
  • Family Medicine
  • Accepts Insurance
  • CLIA Number: 50D0721425
  • 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 Mukilteo, Washington operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1124279237 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 . The authorized official of this NPI record is Donald Wayne Anderson Jr. (Assistant Secretary Of Enrollments)

NPI
1124279237
Provider Legal Name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
4112 HARBOUR POINTE BLVD SW SUITE 100 MUKILTEO, WA 98275
Location Phone
(425) 347-6330
Location Fax
(425) 347-6335
Mailing Address
PO BOX 31001-4114 PASADENA, CA 91110
Mailing Phone
(425) 358-9786
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-07-2008
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)
1207R00000XAllopathic & Osteopathic Physicians

Internal Medicine

 
2208000000XAllopathic & Osteopathic Physicians

Pediatrics

 
3332B00000XSuppliers

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DONALD WAYNE ANDERSON JR.

Authorized Official Title
ASSISTANT SECRETARY OF ENROLLMENTS
Authorized Official Phone
(425) 358-9786

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
50D0721425
Facility Type
Physician Office
Certificate Effective Date
September 01, 1992
Certificate Expiration Date
April 04, 2028
Laboratory Director
KATHERINE BUMSTEAD
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Providence Health & Services - Washington in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

Reviews for PROVIDENCE HEALTH & SERVICES - WASHINGTON

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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 1124279237, we treat the final digit (7) 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 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).

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.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
2
Doubled → 4
Pos 4
4
Unchanged
Pos 5
2
Doubled → 4
Pos 6
7
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
2
Unchanged
Pos 9
3
Doubled → 6
Check
7
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 2 → 4 2 → 4 9 → 18 → 9 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 4 + 4 + 4 + 7 + 1 + 8 + 2 + 6 + 24 = 63

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 63 is 70. The difference is the calculated check digit.

70 - 63 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1124279237.

Other Providers at the Same Location


The following 10 providers are registered at the same or a nearby location.

Dentist (General Practice)
4112 HARBOUR POINTE BLVD SW, SUITE 200
MUKILTEO, WA 98275
Family Medicine
4112 HARBOUR POINTE BLVD SW, SUITE 100
MUKILTEO, WA 98275
Family Medicine
4112 HARBOUR POINTE BLVD SW, SUITE 100
MUKILTEO, WA 98275
Nurse Practitioner (Family)
4112 HARBOUR POINTE BLVD SW, SUITE 100
MUKILTEO, WA 98275
Pediatrics
4112 HARBOUR POINTE BLVD SW, STE 100
MUKILTEO, WA 98275
Family Medicine
4112 HARBOUR POINTE BLVD SW, STE 100
MUKILTEO, WA 98275
Pediatrics
4112 HARBOUR POINTE BLVD SW, STE 100
MUKILTEO, WA 98275
Internal Medicine
4112 HARBOUR POINTE BLVD SW
MUKILTEO, WA 98275
General Practice
4112 HARBOUR POINTE BLVD SW, SUITE100
MUKILTEO, WA 98275
Internal Medicine (Cardiovascular Disease)
4112 HARBOUR POINTE BLVD SW, SUITE 100
MUKILTEO, WA 98275

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1124279237, enumerated as an "organization" on October 07, 2008.

The provider is located at 4112 HARBOUR POINTE BLVD SW SUITE 100 MUKILTEO, WA 98275 and the phone number is (425) 347-6330.

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.