LACEY FAMILY CLINIC
NPI 1508431693
Clinic/Center - Primary Care in Lacey, WA
About Lacey Family Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LACEY FAMILY CLINIC (NPI 1508431693) is a healthcare organization registered as a primary care in Lacey, Washington and active in the NPI registry since May 2021. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Nayeon Kim, Owner/manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 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)
Lacey Family Clinic 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 Lacey Family Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 50D2257273
Lacey Family Clinic · Lacey, 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 Nayeon Kim PLLC's NPI number?
The NPI number for Nayeon Kim PLLC is 1508431693. It was assigned to this organization in the NPPES registry on May 21, 2021. The provider is doing business as Lacey Family Clinic.
Where is Nayeon Kim PLLC located?
Nayeon Kim PLLC is located at 7503 Pacific Ave SE, Lacey, WA 98503. The listed phone number is (253) 332-0892.
What is Nayeon Kim PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Nayeon Kim PLLC enrolled in Medicare?
Yes. Nayeon Kim PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Nayeon Kim PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Nayeon Kim PLLC. 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 Nayeon Kim PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 50D2257273) 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 Nayeon Kim PLLC accept?
Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Nayeon Kim 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 Nayeon Kim PLLC was last updated on July 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Lacey Family Clinic · NPI 1508431693
Primary Care organization in Lacey, Washington. Organization record, active in the CMS NPPES registry since May 21, 2021.
## Identity
- **NPI:** 1508431693 (Entity type: Organization)
- **Enumerated:** May 21, 2021
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Legal business name:** Nayeon Kim Pllc
- **Organization subpart:** No
- **Authorized official:** Nayeon Kim, OWNER/MANAGER
## Practice location
- **Address:** 7503 PACIFIC AVE SE, Lacey, WA 98503-1874
- **Phone:** (253) 332-0892
## 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:** July 15, 2021
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1508431693) · Data from the CMS NPPES public registry.