THE EVERETT CLINIC, PLLC (NPI# 1255950572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255950572 |
| Entity Type | Organization |
| Organization Name | THE EVERETT CLINIC, PLLC |
| Practice Address |
528 Myrtle Street Laconner WA 98257 |
| Mailing Address |
Po Box 5127 Everett WA 98206-5127 |
| Practice Telephone | 3604663136 |
| Mailing Telephone | 3604663136 |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-04-16 |
| Authorized Official Name | SHAWN SLACK (BOARD PRESIDENT) |
| Authorized Official Telephone | 4253395445 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| The Everett Clinic at La Conner Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770006330 | The Everett Clinic, Pllc | Clinical Medical Laboratory | 18505 Bothell Way Ne Ste 215, Bothell, WA 98011-3717 | 2017-07-25 |
| 1861928830 | The Everett Clinic, Pllc | Clinical Medical Laboratory | 17000 140th Ave Ne Unit 101, Woodinville, WA 98072-6928 | 2017-05-11 |
| 1598205908 | The Everett Clinic, Pllc | Family Medicine | 11800 Ne 128th St Ste 560, Kirkland, WA 98034-7208 | 2017-03-03 |
| 1619575933 | The Everett Clinic, Pllc | Non-Pharmacy Dispensing Site | 1717 13th St, Everett, WA 98201-1621 | 2020-10-09 |
| 1144837345 | The Everett Clinic, Pllc | Clinical Medical Laboratory | 11019 Canyon Rd E Ste A, Puyallup, WA 98373-3001 | 2020-09-30 |
| 1629698964 | The Everett Clinic, Pllc | Family Medicine | 912 32nd St Ste A, Anacortes, WA 98221-3473 | 2020-04-16 |
| 1689144388 | The Everett Clinic, Pllc | Family Medicine | 1200 112th Ave Ne Ste C160, Bellevue, WA 98004-3742 | 2018-11-26 |
| 1275074544 | The Everett Clinic, Pllc | Durable Medical Equipment & Medical Supplies | 21401 72nd Ave W, Edmonds, WA 98026-7702 | 2017-03-20 |
| 1164972527 | The Everett Clinic, Pllc | Internal Medicine | 3916 148th St Se, Mill Creek, WA 98012-4751 | 2016-10-10 |
| 1467907287 | The Everett Clinic, Pllc | Durable Medical Equipment & Medical Supplies | 21401 72nd Ave W, Edmonds, WA 98026-7702 | 2016-08-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | THE EVERETT CLINIC, PLLC | 3901 Hoyt Ave, Everett, WA 98201-4918 |
| Street Address |
528 MYRTLE STREET |
| City | LACONNER |
| State | WA |
| Zip Code | 98257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568088144 | Rsl La Conner, LLC | Assisted Living Facility | 204 N. 1st St, La Conner, WA 98257 | 2020-06-19 |
| 1205302262 | Thanh Nguyen | Pharmacist | 708 E. Morris St, La Conner, WA 98257 | 2018-10-17 |
| 1023590197 | Melissa Danielle Adair | Nurse Practitioner | 708 Morris Street, Suite B, La Conner, WA 98257 | 2018-09-05 |
| 1013363886 | Steven Bruce Gooding | Counselor | 17400 Reservation Rd., La Conner, WA 98257 | 2016-05-10 |
| 1639550643 | Skagit County Fire District 13 | Ambulance | 17433 Snee-oosh Rd, La Conner, WA 98257 | 2015-06-16 |
| 1679909360 | Nina Marie Wawrzyniec | Chiropractor | 125 Washington Street, Laconner, WA 98257 | 2013-09-25 |
| 1669805180 | Reidun E Pederson | Registered Nurse | 403 State St., La Conner, WA 98257 | 2013-08-20 |
| 1326390527 | Susan Jane Erickson | Speech-Language Pathologist | 305 N. 6th, La Conner, WA 98257 | 2012-10-11 |
| 1528331469 | Charles Evert Larsson | Family Medicine | 528 Myrtle Avenue, La Conner, WA 98257 | 2012-02-22 |
| 1720356876 | La Conner Health and Wellness LLC | Clinic/Center | 413 Morris St., La Conner, WA 98257 | 2011-12-05 |
| Find all providers in zip 98257 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382224 | Heart Central of Washington | Internal Medicine | 1006 S 64th Ave Ste 110, Yakima, WA 98908-2090 | 2020-10-07 |
| 1265049829 | Robert I Hustrulid Md Pllc | Internal Medicine | 3807 S Sommer Rd, Veradale, WA 99037-9136 | 2020-09-28 |
| 1659987485 | David James Sanders | Internal Medicine | 1100 Ninth Avenue: Attention David Sanders, G2-pmr, Seattle, WA 98101 | 2020-09-17 |
| 1710590179 | Direct Urgent Care Inc | Internal Medicine | 220 6th Avenue North, Seattle, WA 98109 | 2020-08-26 |
| 1740898766 | Abx Medical Pllc | Internal Medicine | 2523 Simon Ln Ne, Olympia, WA 98506-3553 | 2020-07-15 |
| 1225656614 | Sentinel Healthcare Corporation | Internal Medicine | 2220 76th Ave Se, Mercer Island, WA 98040-2114 | 2020-07-11 |
| 1730718628 | Brendan Eugene Raney | Internal Medicine | 202 N Borough Rd, Tacoma, WA 98403-2804 | 2020-04-03 |
| 1609404136 | Abigail Anne Cano Deleon | Internal Medicine | 4252 E Roosevelt Ave, Tacoma, WA 98404-4658 | 2020-03-30 |
| 1528691706 | Blue Med Inc. | Internal Medicine | 1222 N Sunset Dr, Tacoma, WA 98406-1027 | 2020-02-17 |
| 1194372896 | Dunia Health Clinic LLC | Internal Medicine | 11625 Rainier Ave S Ste 102, Seattle, WA 98178-3983 | 2019-08-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.