PRIMARY CARE CLINIC FOR ADULTS LLC
NPI 1386828846
Nurse Practitioner in Shoreline, WA
About Primary Care Clinic For Adults Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIMARY CARE CLINIC FOR ADULTS LLC (NPI 1386828846) is a healthcare organization registered as a nurse practitioner in Shoreline, Washington and active in the NPI registry since December 2007. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Jaclyn R Wilson, Medical Assistant, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Primary Care Clinic For Adults Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Primary Care Clinic For Adults LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Shoreline, WA 98155
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Waiver 50D1046297
A Primary Care Clinic For Adults · Shoreline, WAFrequently 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 Primary Care Clinic For Adults LLC's NPI number?
The NPI number for Primary Care Clinic For Adults LLC is 1386828846. It was assigned to this organization in the NPPES registry on December 19, 2007.
Where is Primary Care Clinic For Adults LLC located?
Primary Care Clinic For Adults LLC is located at 20011 Ballinger Way NE Ste 202, Shoreline, WA 98155. The listed phone number is (425) 806-8360.
What is Primary Care Clinic For Adults LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Primary Care Clinic For Adults LLC enrolled in Medicare?
Yes. Primary Care Clinic For Adults LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Primary Care Clinic For Adults LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Primary Care Clinic For Adults LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Primary Care Clinic For Adults LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 50D1046297) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Primary Care Clinic For Adults LLC accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Primary Care Clinic For Adults LLC 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 Primary Care Clinic For Adults LLC was last updated on April 11, 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.
# Primary Care Clinic For Adults Llc · NPI 1386828846
Nurse Practitioner organization in Shoreline, Washington. Organization record, active in the CMS NPPES registry since December 19, 2007.
## Identity
- **NPI:** 1386828846 (Entity type: Organization)
- **Enumerated:** December 19, 2007
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **Organization subpart:** No
- **Authorized official:** Jaclyn Wilson, MEDICAL ASSISTANT
## Practice location
- **Address:** 20011 BALLINGER WAY NE STE 202, Shoreline, WA 98155-1286
- **Phone:** (425) 806-8360 · **Fax:** (425) 250-8566
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 11, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1386828846) · Data from the CMS NPPES public registry.