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OPTUM TACOMA
NPI 1831411487
Durable Medical Equipment & Medical Supplies in Tacoma, WA

Active since February 24, 2010CLIA 50D2217781 · Waiver
1812 S J ST STE 102, TACOMA, WA 98405(253) 552-4900 Get Directions Write a Review

NPPES record last updated: October 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 3, 2024, Sep 26, 2024, Mar 22, 2016 (3 updates tracked since 2016).

About Optum Tacoma NPPES

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

OPTUM TACOMA (NPI 1831411487) is a healthcare organization registered as a durable medical equipment & medical supplies in Tacoma, Washington and active in the NPI registry since February 2010. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Craig Pepin, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1831411487
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameTHE POLYCLINIC PLLC
Location Address1812 S J ST STE 102Tacoma, WA 98405-4965
Mailing Address1145 BroadwaySeattle, WA 98122-4201 · (206) 860-5414 · Fax (206) 720-8462
Phone(253) 552-4900
Organization SubpartNo
Authorized OfficialCraig PepinPhysician/owner · (206) 860-5414
Enumeration DateFebruary 24, 2010
Last NPPES UpdateOctober 3, 20243 updates tracked since enumeration
NPPES CertifiedOctober 3, 2024
✔ NPI 1831411487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ 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 ListedSurgeryTaxonomy 208600000X
Also ListedSurgery · Vascular SurgeryTaxonomy 2086S0129X
Also ListedUrologyTaxonomy 208800000X
1812 S J ST STE 102, Tacoma, WA 98405
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Other Names 1

Doing Business AsOptum Tacoma

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 Waiver 50D2217781

The Polyclinic Dba Optumcare Washington · Tacoma, WA
Active · expires Apr 4, 2028
CLIA Number50D2217781
Laboratory TypeCommunity Clinic
Certificate Effective DateApril 8, 2025
Certificate Expiration DateApril 4, 2028
Laboratory DirectorMichael Bateman
Laboratory Phone(253) 552-4900
Laboratory LocationThe Polyclinic Dba Optumcare Washington1812 South J Street Ste 102, Tacoma, WA 98405
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 7

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

MICHAEL J BATEMAN MD
Family Medicine
1812 S J ST STE 102
TACOMA, WA 98405
Pierce County (253) 552-4900
KARA ZADA PA-C
Physician Assistant
1812 S J ST STE 102
TACOMA, WA 98405
Pierce County (253) 552-4900
SYDNI L WRIGHT ARNP
Nurse Practitioner (Family)
1812 S J ST STE 102
TACOMA, WA 98405
Pierce County (253) 552-4900
DEBORA ROBINETT M.A., R.D.
Dietitian, Registered
1812 S J ST STE 102
TACOMA, WA 98405
Pierce County (253) 556-1616
CHARLES M WEATHERBY MD
Family Medicine
1812 S J ST STE 102
TACOMA, WA 98405
Pierce County (253) 552-4900
MS. PAULA JANISE SMITH ARNP
Nurse Practitioner (Family)
1812 S J ST STE 102
TACOMA, WA 98405
Pierce County (253) 552-4900
DR. REID D HOLTZCLAW-SWAN MD
Internal Medicine
1812 S J ST STE 102
TACOMA, WA 98405
Pierce County (253) 537-0293

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 The Polyclinic PLLC's NPI number?

The NPI number for The Polyclinic PLLC is 1831411487. It was assigned to this organization in the NPPES registry on February 24, 2010. The provider is doing business as Optum Tacoma.

Where is The Polyclinic PLLC located?

The Polyclinic PLLC is located at 1812 S J St Ste 102, Tacoma, WA 98405. The listed phone number is (253) 552-4900.

What is The Polyclinic PLLC's specialty?

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

Does The Polyclinic PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2217781) 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 The Polyclinic PLLC was last updated on October 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.