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CHYMIYMATTYMDLLC
NPI 1831563600
Family Medicine in Poulsbo, WA

Active since November 17, 2015CLIA Certified · 2 labs
19036 FRONT ST NE # 100, POULSBO, WA 98370(360) 979-0569(877) 805-9505 Get Directions Write a Review

NPPES record last updated: July 27, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 27, 2024, Apr 10, 2019, Nov 17, 2015 (3 updates tracked since 2015).

About Chymiymattymdllc NPPES

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

CHYMIYMATTYMDLLC (NPI 1831563600) is a healthcare organization registered as a family medicine in Poulsbo, Washington and active in the NPI registry since November 2015. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Bainbridge Island, and lists Marie Matty, Owner, as its authorized official.

NPPES Registry Identity

NPI1831563600
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePACIFICA MEDICINE
Location Address19036 FRONT ST NE # 100Poulsbo, WA 98370-7354
Mailing AddressPo Box 2940Poulsbo, WA 98370-2940 · (360) 297-8805 · Fax (360) 297-1676
Phone(360) 979-0569
Fax(877) 805-9505
Organization SubpartNo
Authorized OfficialMarie MattyOwner · (360) 297-8805
Enumeration DateNovember 17, 2015
Last NPPES UpdateJuly 27, 20243 updates tracked since enumeration
NPPES CertifiedJuly 27, 2024
✔ NPI 1831563600 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
19036 FRONT ST NE # 100, Poulsbo, WA 98370
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Other Names 1

Other NameChymiymattymdllc

Secondary Practice Location 1

Location 11173 Madison Ave NBainbridge Island, WA 98110-1782 · Phone (360) 979-0569

Other Identifiers 2

Other1871543900WA · Npi
Other1740224880WA · Npi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

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 50D2255985

Pacifica Medicine & Wellness · Bainbridge Island, WA
Active · expires Apr 4, 2028
CLIA Number50D2255985
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2022
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAndrea Chymiy
Laboratory Phone(360) 979-0569
Laboratory LocationPacifica Medicine & Wellness1173 Madison Ave N, Bainbridge Island, WA 98110
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 50D2108445

Pacifica Medicine And Wellness · Poulsbo, WA
Active · expires Apr 4, 2028
CLIA Number50D2108445
Laboratory TypePhysician Office
Certificate Effective DateFebruary 4, 2016
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAndrea L. Chymiy
Laboratory Phone(360) 979-0569
Laboratory LocationPacifica Medicine And Wellness19980 10th Ave NE Ste 202, Poulsbo, WA 98370
CLIA data matches this NPI record on: Name Phone
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.

CHYMIYMATTYMD LLC
Family Medicine
19036 FRONT ST NE # 100
POULSBO, WA 98370
Kitsap County (360) 979-0569

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 Pacifica Medicine's NPI number?

The NPI number for Pacifica Medicine is 1831563600. It was assigned to this organization in the NPPES registry on November 17, 2015. The provider is also known as Chymiymattymdllc.

Where is Pacifica Medicine located?

Pacifica Medicine is located at 19036 Front St NE # 100, Poulsbo, WA 98370. The listed phone number is (360) 979-0569.

What is Pacifica Medicine's specialty?

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

Does Pacifica Medicine hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Pacifica Medicine was last updated on July 27, 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.