N/A
NPI 1699364455
Family Medicine in Federal Way, WA

Active since January 15, 2021CLIA 50D2233945 · Waiver
1045 S 320TH ST STE 7, FEDERAL WAY, WA 98003(206) 212-6554 Get Directions Write a Review

NPPES record last updated: July 13, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 13, 2023, Mar 30, 2021, Jan 15, 2021 (3 updates tracked since 2021).

About N/a NPPES

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

N/A (NPI 1699364455) is a healthcare organization registered as a family medicine in Federal Way, Washington and active in the NPI registry since January 2021. The organization holds a CLIA Waiver certificate valid through April 4, 2028, maintains 2 additional practice locations, and lists Kristyn Dice, Contracting Manager, as its authorized official.

NPPES Registry Identity

NPI1699364455
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePRUDENT MEDICAL PROVIDERS NW
Location Address1045 S 320TH ST STE 7Federal Way, WA 98003-5179
Mailing Address4523 42nd St NeTacoma, WA 98422-2424 · (206) 245-4902
Organization SubpartNo
Authorized OfficialKristyn DiceContracting Manager · (208) 717-3944
Enumeration DateJanuary 15, 2021
Last NPPES UpdateJuly 13, 20233 updates tracked since enumeration
NPPES CertifiedJuly 29, 2021
NPI 1699364455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

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.
Also ListedPhysician AssistantTaxonomy 363A00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
1045 S 320TH ST STE 7, Federal Way, WA 98003

Secondary Practice Locations 2

Location 14523 42nd St NETacoma, WA 98422-2424 · Phone (206) 245-4902
Location 24306 40th Ave NETacoma, WA 98422-2488 · Phone (206) 245-4902

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

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 50D2233945

Prudent Medical Providers · Federal Way, WA
Active · expires Apr 4, 2028
CLIA Number50D2233945
Laboratory TypeArnp
Certificate Effective DateAugust 26, 2021
Certificate Expiration DateApril 4, 2028
Laboratory DirectorSarah Phillips
Laboratory Phone(206) 651-7920
Laboratory LocationPrudent Medical Providers1045 S 320th St Ste 7, Federal Way, WA 98003
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Nurse Practitioner (Family)
1045 S 320TH ST STE 7
FEDERAL WAY, WA 98003

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 Prudent Medical Providers NW's NPI number?

The NPI number for Prudent Medical Providers NW is 1699364455. It was assigned to this organization in the NPPES registry on January 15, 2021.

Where is Prudent Medical Providers NW located?

Prudent Medical Providers NW is located at 1045 S 320th St Ste 7, Federal Way, WA 98003. The listed phone number is (206) 212-6554.

What is Prudent Medical Providers NW's specialty?

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

Does Prudent Medical Providers NW hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2233945) 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 Prudent Medical Providers NW accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Prudent Medical Providers NW 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 Prudent Medical Providers NW was last updated on July 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.