Primary Care Clinic for Adults LLC
NPI 1386828846ActiveOrganization· Nurse Practitioner· Shoreline, WA
Nurse Practitioner in Shoreline, Washington, registered in NPPES in December 2007. The authorized official on file is Jaclyn R. Wilson, MA, Medical Assistant. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1386828846 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 19, 2007 |
| Last updated in NPPES | Apr 11, 2023 |
| Certified by provider | Apr 11, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | AP30005666 | WA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (WA) |
|---|
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