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OPTUM - DERMATOLOGY DME 2
NPI 1619138617
Durable Medical Equipment & Medical Supplies in Everett, WA

Active since June 23, 2008
4004 COLBY AVE, EVERETT, WA 98201(425) 339-5417 Get Directions Write a Review

NPPES record last updated: April 10, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 10, 2024, Dec 13, 2017, Nov 21, 2017 (3 updates tracked since 2017).

About Optum - Dermatology Dme 2 NPPES

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

OPTUM - DERMATOLOGY DME 2 (NPI 1619138617) is a healthcare organization registered as a durable medical equipment & medical supplies in Everett, Washington and active in the NPI registry since June 2008. The organization lists George Go, Board President, as its authorized official.

NPPES Registry Identity

NPI1619138617
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameOPTUM CARE WASHINGTON PLLC
Location Address4004 COLBY AVEEverett, WA 98201-6203
Mailing AddressPo Box 5127Everett, WA 98206-5127
Phone(425) 339-5417
Organization SubpartNo
Authorized OfficialGeorge GoBoard President · (425) 259-0966
Enumeration DateJune 23, 2008
Last NPPES UpdateApril 10, 20243 updates tracked since enumeration
NPPES CertifiedApril 10, 2024
✔ NPI 1619138617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
4004 COLBY AVE, Everett, WA 98201
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Other Names 1

Other NameOptum - Dermatology Dme 2

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Optum - Dermatology Dme 2 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateWashingtonEnrollment IDO20110722000005DME · Physician - Physical and RehabilitationDue dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES 14

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

JANE M NOSAL MD
Dermatology
4004 COLBY AVE
EVERETT, WA 98201
Snohomish County (425) 259-0966
OPTUM CARE WASHINGTON PLLC
Durable Medical Equipment & Medical Supplies
4004 COLBY AVE
EVERETT, WA 98201
Snohomish County (425) 339-5417
CALVIN HORACE KNAPP III MD
Dermatology
4004 COLBY AVE
EVERETT, WA 98201
Snohomish County (425) 339-5417
DR. ZARRY TAVAKKOL M.D.
Dermatology
4004 COLBY AVE
EVERETT, WA 98201
Snohomish County (425) 339-5417
HANA KATHRYN STELLE M.D.
Dermatology
4004 COLBY AVE
EVERETT, WA 98201
Snohomish County (425) 339-5417
LUCY CHAO MD
Dermatology
4004 COLBY AVE
EVERETT, WA 98201
Snohomish County (425) 339-5417
MARSHALL LEWIS BATCHELOR DDS
Dentist (Endodontics)
4004 COLBY AVE
EVERETT, WA 98201
Snohomish County (425) 258-4461
DR. DAVID IAN SMITH M.D.
Dermatology
4004 COLBY AVE
EVERETT, WA 98201
Snohomish County (425) 339-5417

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 Optum Care Washington PLLC's NPI number?

The NPI number for Optum Care Washington PLLC is 1619138617. It was assigned to this organization in the NPPES registry on June 23, 2008. The provider is also known as Optum - Dermatology Dme 2.

Where is Optum Care Washington PLLC located?

Optum Care Washington PLLC is located at 4004 Colby Ave, Everett, WA 98201. The listed phone number is (425) 339-5417.

What is Optum Care Washington PLLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Is Optum Care Washington PLLC enrolled in Medicare?

Yes. Optum Care Washington PLLC is registered in the Medicare PECOS enrollment system.

When is Optum Care Washington PLLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Washington, Physician - Physical, Rehabilitation) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

When was this NPI record last updated?

The NPPES record for Optum Care Washington PLLC was last updated on April 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.