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OPTUM - LA CONNER MEDICAL CENTER
NPI 1255950572
Internal Medicine in Laconner, WA

Active since April 16, 2020CLIA 50D0679370 · Certificate of Compliance
528 MYRTLE STREET, LACONNER, WA 98257(360) 466-3136 Get Directions Write a Review

NPPES record last updated: April 9, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 9, 2024, Apr 16, 2020 (2 updates tracked since 2020).

About Optum - La Conner Medical Center NPPES

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

OPTUM - LA CONNER MEDICAL CENTER (NPI 1255950572) is a healthcare organization registered as an internal medicine in Laconner, Washington and active in the NPI registry since April 2020. 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

NPI1255950572
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameOPTUM CARE WASHINGTON PLLC
Location Address528 MYRTLE STREETLaconner, WA 98257
Mailing AddressPo Box 5127Everett, WA 98206-5127 · (360) 466-3136
Phone(360) 466-3136
Organization SubpartYesParent: Everett Physicians, Inc. P.s.
Authorized OfficialGeorge GoBoard President · (425) 259-0966
Enumeration DateApril 16, 2020
Last NPPES UpdateApril 9, 20242 updates tracked since enumeration
NPPES CertifiedApril 9, 2024
✔ NPI 1255950572 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
528 MYRTLE STREET, Laconner, WA 98257
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Other Names 1

Other NameOptum - La Conner Medical Center

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 50D0679370

Optum Care Washington, PLLC · La Conner, WA
Active · expires Apr 4, 2028
CLIA Number50D0679370
Laboratory TypePhysician Office
Certificate Effective DateDecember 1, 2021
Certificate Expiration DateApril 4, 2028
Laboratory DirectorHelen W. Young
Laboratory Phone(360) 466-3136
Laboratory LocationOptum Care Washington, PLLC528 Myrtle St, La Conner, WA 98257
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.

Other Providers at the Same Location NPPES

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

DR. BENNETT WAYNE PAFFORD M.D.
Internal Medicine
528 MYRTLE STREET
LA CONNER, WA 98257
Skagit County (360) 446-3136

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 1255950572. It was assigned to this organization in the NPPES registry on April 16, 2020. The provider is also known as Optum - La Conner Medical Center.

Where is Optum Care Washington PLLC located?

Optum Care Washington PLLC is located at 528 Myrtle Street, Laconner, WA 98257. The listed phone number is (360) 466-3136.

What is Optum Care Washington PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Optum Care Washington PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 50D0679370) 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 9, 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.