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REJUVENATION MEDICAL PLLC
NPI 1447712559
Family Medicine in Shoreline, WA

Active since April 05, 2019CLIA 50D2338019 · Waiver
20011 BALLINGER WAY NE, SHORELINE, WA 98155(206) 407-4171(206) 906-9981 Get Directions Write a Review

NPPES record last updated: April 5, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Rejuvenation Medical Pllc NPPES

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

REJUVENATION MEDICAL PLLC (NPI 1447712559) is a healthcare organization registered as a family medicine in Shoreline, Washington and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Joshua Kretchmar, Do, as its authorized official.

NPPES Registry Identity

NPI1447712559
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameREJUVENATION MEDICAL PLLC
Location Address20011 BALLINGER WAY NEShoreline, WA 98155-1286
Mailing Address20011 Ballinger Way NeShoreline, WA 98155-1286 · (206) 407-4171
Phone(206) 407-4171
Fax(206) 906-9981
Organization SubpartNo
Authorized OfficialJoshua KretchmarDo · (817) 789-2639
Enumeration DateApril 5, 2019
✔ NPI 1447712559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
20011 BALLINGER WAY NE, Shoreline, WA 98155
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Other Identifiers 1

OtherOP60765453WA · License

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

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 50D2338019

Rejuvenation Medical · Edgewood, WA
Active · expires Apr 4, 2028
CLIA Number50D2338019
Laboratory TypePhysician Office
Certificate Effective DateFebruary 3, 2026
Certificate Expiration DateApril 4, 2028
Laboratory DirectorJoshua Kretchmar
Laboratory Phone(206) 407-4171
Laboratory LocationRejuvenation Medical2222 Meridian Ave E Ste A, Edgewood, WA 98371
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

MS. CAROLINE M TIMMINS MS, LMFT
Marriage & Family Therapist
20011 BALLINGER WAY NE
SHORELINE, WA 98155
King County (360) 710-3886
DR. MICHAEL S CAPARAS D.M.D.
Dentist (General Practice)
20011 BALLINGER WAY NE, SUITE B100
SHORELINE, WA 98155
King County (206) 946-6471
PAULA R. JOHNSON PT
Physical Therapist
20011 BALLINGER WAY NE, C100
SHORELINE, WA 98155
King County (206) 367-6069
LAKE FOREST PARK PHYSICAL THERAPY, PLLC
Clinic/Center (Physical Therapy)
20011 BALLINGER WAY NE, STE C100
SHORELINE, WA 98155
King County (206) 367-6069

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 Rejuvenation Medical PLLC's NPI number?

The NPI number for Rejuvenation Medical PLLC is 1447712559. It was assigned to this organization in the NPPES registry on April 5, 2019.

Where is Rejuvenation Medical PLLC located?

Rejuvenation Medical PLLC is located at 20011 Ballinger Way NE, Shoreline, WA 98155. The listed phone number is (206) 407-4171.

What is Rejuvenation Medical PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Rejuvenation Medical PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2338019) 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 Rejuvenation Medical PLLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Rejuvenation Medical PLLC 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 Rejuvenation Medical PLLC was last updated on April 5, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.