1. Home
  2. Directory
  3. Washington
  4. Mill Creek
  5. Durable Medical Equipment Medical Supplies
  6. NPI Profile

OPTUM - THOMAS LAKE
NPI 1164972527
Durable Medical Equipment & Medical Supplies in Mill Creek, WA

Active since October 10, 2016CLIA 50D1060436 · Certificate of Compliance
3916 148TH ST SE, MILL CREEK, WA 98012(425) 304-1100(425) 304-1102 Get Directions Write a Review

NPPES record last updated: April 8, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 8, 2024, Feb 9, 2024, Mar 29, 2018 and 1 more (4 updates tracked since 2016).

About Optum - Thomas Lake NPPES

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

OPTUM - THOMAS LAKE (NPI 1164972527) is a healthcare organization registered as a durable medical equipment & medical supplies in Mill Creek, Washington and active in the NPI registry since October 2016. The organization holds a CLIA Certificate of Compliance certificate valid through April 4, 2028 and lists George Go, Board President, as its authorized official.

NPPES Registry Identity

NPI1164972527
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameOPTUM CARE WASHINGTON PLLC
Location Address3916 148TH ST SEMill Creek, WA 98012-4751
Mailing AddressPo Box 5127Everett, WA 98206-5127 · (425) 304-1100 · Fax (425) 304-1102
Phone(425) 304-1100
Fax(425) 304-1102
Organization SubpartYesParent: Everett Physicians, Inc. P.s.
Authorized OfficialGeorge GoBoard President · (425) 259-0966
Enumeration DateOctober 10, 2016
Last NPPES UpdateApril 8, 20244 updates tracked since enumeration
NPPES CertifiedApril 8, 2024
✔ NPI 1164972527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
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.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
3916 148TH ST SE, Mill Creek, WA 98012
Open in Google Maps ↗

Other Names 1

Other NameOptum - Thomas Lake

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 50D1060436

Optum Care Washington, PLLC · Mill Creek, WA
Active · expires Apr 4, 2028
CLIA Number50D1060436
Laboratory TypePhysician Office
Certificate Effective DateOctober 23, 2006
Certificate Expiration DateApril 4, 2028
Laboratory DirectorYuan PO Tu
Laboratory Phone(425) 317-3460
Laboratory LocationOptum Care Washington, PLLC15418 Main St Unit 200, Mill Creek, WA 98012
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 7

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

DR. JOHN FRANCIS MCGUIGAN PHD
Psychologist
3916 148TH ST SE
MILL CREEK, WA 98012
Snohomish County (425) 339-5453
CHRISTINA SUJIN THEIS ARNP
Nurse Practitioner (Family)
3916 148TH ST SE
MILL CREEK, WA 98012
Snohomish County (425) 332-6948
JOHN FRANCIS SCHULZE
Counselor (Mental Health)
3916 148TH ST SE
MILL CREEK, WA 98012
Snohomish County (425) 339-5453
KAREN MITRAKUL DEGUZMAN
Counselor (Mental Health)
3916 148TH ST SE
MILL CREEK, WA 98012
Snohomish County (425) 339-5453
MRS. KELLY L. KLOTTER PHYSICAL THERAPIST
Physical Therapist (Orthopedic)
3916 148TH ST SE
MILL CREEK, WA 98012
Snohomish County (425) 304-1100
DR. CHRISTIAN HERTER MD
Family Medicine
3916 148TH ST SE
MILL CREEK, WA 98012
Snohomish County (425) 332-6948
KIMBERLY SCHWITTAY
Nurse Practitioner
3916 148TH ST SE
MILL CREEK, WA 98012
Snohomish County (425) 304-1100

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 1164972527. It was assigned to this organization in the NPPES registry on October 10, 2016. The provider is also known as Optum - Thomas Lake.

Where is Optum Care Washington PLLC located?

Optum Care Washington PLLC is located at 3916 148th St SE, Mill Creek, WA 98012. The listed phone number is (425) 304-1100.

What is Optum Care Washington PLLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Optum Care Washington PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 50D1060436) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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.