Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Optum Care Washington PLLC

Organization Family Medicine Physician · NPI 1164972527

Optum Care Washington PLLC is a Family Medicine Physician in Mill Creek, Washington. Licensed in Washington. Registered with an NPI since 2016.

Licensed in
WA
In the registry since
2016
Specialties on file
5
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3916 148th St SE
Mill Creek, WA 98012-4751
Phone: (425) 304-1100
Fax: (425) 304-1102
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Durable Medical Equipment & Medical Supplies (primary) Taxonomy 332B00000X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Pediatrics Physician Taxonomy 208000000X
Clinical Medical Laboratory Taxonomy 291U00000X (WA)

Record details

NPI number1164972527
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationEverett Physicians, Inc P.s.
Authorized official George Go — Board President · (425) 259-0966
Other names Optum - Thomas Lake
NPI enumeratedOctober 10, 2016
Last updated in NPPESApril 8, 2024
Certification dateApril 8, 2024
Mailing addressPo Box 5127, Everett, WA 98206-5127

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