1. Home
  2. Directory
  3. Washington
  4. Shoreline
  5. Nurse Practitioner
  6. NPI Profile

PRIMARY CARE CLINIC FOR ADULTS LLC
NPI 1386828846
Nurse Practitioner in Shoreline, WA

Active since December 19, 2007CLIA 50D1046297 · Waiver
20011 BALLINGER WAY NE STE 202, SHORELINE, WA 98155(425) 806-8360(425) 250-8566 Get Directions Write a Review

NPPES record last updated: April 11, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 11, 2023, Mar 23, 2023, Dec 16, 2015 (3 updates tracked since 2015).

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

NPI1386828846
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NamePRIMARY CARE CLINIC FOR ADULTS LLC
Location Address20011 BALLINGER WAY NE STE 202Shoreline, WA 98155-1286
Mailing Address20011 Ballinger Way Ne Ste 202Shoreline, WA 98155-1286 · (425) 806-8360 · Fax (425) 250-8566
Phone(425) 806-8360
Fax(425) 250-8566
Organization SubpartNo
Authorized OfficialJaclyn R WilsonMedical Assistant · (425) 806-8360
Enumeration DateDecember 19, 2007
Last NPPES UpdateApril 11, 20233 updates tracked since enumeration
NPPES CertifiedApril 11, 2023
✔ NPI 1386828846 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in WA · AP30005666
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
20011 BALLINGER WAY NE STE 202, Shoreline, WA 98155
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

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, WA
Active · expires Apr 4, 2028
CLIA Number50D1046297
Laboratory TypeOther
Certificate Effective DateOctober 5, 2005
Certificate Expiration DateApril 4, 2028
Laboratory DirectorMary D. White
Laboratory Phone(425) 806-8360
Laboratory LocationA Primary Care Clinic For Adults20011 Ballinger Way NE Ste 202, Shoreline, WA 98155
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

MRS. MARY DIANE WHITE MSN, ARNP, FNP
Nurse Practitioner
20011 BALLINGER WAY NE STE 202
SHORELINE, WA 98155
King County (425) 806-8360

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 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.

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.