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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

REJUVENATION MEDICAL PLLC
NPI 1447712559
Family Medicine in Edgewood, WA

Active since April 05, 2019CLIA 50D2338019 · Waiver
2222 MERIDIAN AVE E STE A, EDGEWOOD, WA 98371(206) 407-4171(253) 294-7069 Get Directions Write a Review

NPPES record last updated: October 2, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Oct 2, 2026, Apr 5, 2019 (2 updates tracked since 2019).

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 Edgewood, 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 B Kretchmar, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1447712559
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameREJUVENATION MEDICAL PLLC
Location Address2222 MERIDIAN AVE E STE AEdgewood, WA 98371-1032
Mailing Address2222 Meridian Ave E Ste AEdgewood, WA 98371-1032 · (206) 407-4171 · Fax (253) 294-7069
Phone(206) 407-4171
Fax(253) 294-7069
Organization SubpartNo
Authorized OfficialJoshua B KretchmarMedical Director · (817) 789-2639
Enumeration DateApril 5, 2019
Last NPPES UpdateOctober 2, 20262 updates tracked since enumeration
NPPES CertifiedOctober 2, 2026
✔ 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.
2222 MERIDIAN AVE E STE A, Edgewood, WA 98371
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Other Identifiers 1

OtherOP60765453WA · License

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: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

MS. JUDITH ANN ABELL MS, NP-BC
Nurse Practitioner (Adult Health)
2222 MERIDIAN AVE E STE A
EDGEWOOD, WA 98371
Pierce County (206) 407-4171
RAMI NOUMAN ALHAKIM MD
Family Medicine
2222 MERIDIAN AVE E STE A
EDGEWOOD, WA 98371
Pierce County (206) 407-4171

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 2222 Meridian Ave E Ste A, Edgewood, WA 98371. 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 October 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 days 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.