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OPTUM - EASTSIDE
NPI 1689144388
Durable Medical Equipment & Medical Supplies in Bellevue, WA

Active since November 26, 2018CLIA 50D0717301 · Certificate of Compliance
1200 112TH AVE NE STE C160, BELLEVUE, WA 98004(425) 453-1039 Get Directions Write a Review

NPPES record last updated: April 10, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 10, 2024, Sep 8, 2022, Nov 27, 2018 (3 updates tracked since 2018).

About Optum - Eastside NPPES

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

OPTUM - EASTSIDE (NPI 1689144388) is a healthcare organization registered as a durable medical equipment & medical supplies in Bellevue, Washington and active in the NPI registry since November 2018. The organization holds a CLIA Certificate of Compliance certificate valid through April 4, 2028 and lists George Go, Board President, as its authorized official.

NPPES Registry Identity

NPI1689144388
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameOPTUM CARE WASHINGTON PLLC
Location Address1200 112TH AVE NE STE C160Bellevue, WA 98004-3742
Mailing AddressPo Box 5127Everett, WA 98206-5127 · (425) 453-1039
Phone(425) 453-1039
Organization SubpartYesParent: Everett Physicians, Inc. P.s.
Authorized OfficialGeorge GoBoard President · (425) 259-0966
Enumeration DateNovember 26, 2018
Last NPPES UpdateApril 10, 20243 updates tracked since enumeration
NPPES CertifiedApril 10, 2024
✔ NPI 1689144388 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ 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.
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedPediatricsTaxonomy 208000000X
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
1200 112TH AVE NE STE C160, Bellevue, WA 98004
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Other Names 1

Other NameOptum - Eastside

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

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 Compliance 50D0717301

Optum Care Washington, PLLC · Bellevue, WA
Active · expires Apr 4, 2028
CLIA Number50D0717301
Laboratory TypePhysician Office
Certificate Effective DateNovember 1, 1993
Certificate Expiration DateApril 4, 2028
Laboratory DirectorDenise S. Kraft
Laboratory Phone(425) 339-5465
Laboratory LocationOptum Care Washington, PLLC1200 112th Ave NE Suite C160, Bellevue, WA 98004
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 8

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

ILANA ADINA SIMON PA-C
Physician Assistant
1200 112TH AVE NE STE C160
BELLEVUE, WA 98004
King County (425) 453-1039
DR. VANESSA HSENZHOO TONG MD
Family Medicine
1200 112TH AVE NE STE C160
BELLEVUE, WA 98004
King County (425) 453-1039
DR. CHI MENG GAN M.D.
Family Medicine
1200 112TH AVE NE STE C160
BELLEVUE, WA 98004
King County (425) 453-1039
MELISSA M VANTASSEL M.D.
Family Medicine
1200 112TH AVE NE STE C160
BELLEVUE, WA 98004
King County (425) 453-1039
RACHEL ALLEN BAKER ARNP
Nurse Practitioner (Psychiatric/Mental Health)
1200 112TH AVE NE STE C160
BELLEVUE, WA 98004
King County (425) 339-5453
MRS. NICOLE JOSEFINA BARRETT MSW, LICSW
Social Worker
1200 112TH AVE NE STE C160
BELLEVUE, WA 98004
King County (425) 339-5453
KERSTIN BEIJER MD
Family Medicine
1200 112TH AVE NE STE C160
BELLEVUE, WA 98004
King County (425) 453-1039
JUNWOO LEE DO
Family Medicine
1200 112TH AVE NE STE C160
BELLEVUE, WA 98004
King County (425) 453-1039

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 1689144388. It was assigned to this organization in the NPPES registry on November 26, 2018. The provider is also known as Optum - Eastside.

Where is Optum Care Washington PLLC located?

Optum Care Washington PLLC is located at 1200 112th Ave NE Ste C160, Bellevue, WA 98004. The listed phone number is (425) 453-1039.

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.

Does Optum Care Washington PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 50D0717301) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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.