Evernorth Care Providers - Arizona PC
NPI 1417731035ActiveOrganization· General Practice· Seattle, WA
General Practice in Seattle, Washington, registered in NPPES in August 2023. The authorized official on file is Grace V. Blue, Credentialing Sr. Manager.
Overview
| NPI | 1417731035 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 23, 2023 |
| Last updated in NPPES | Mar 27, 2024 |
| Certified by provider | Mar 20, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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