Prudent Medical Providers Nw
NPI 1699364455ActiveOrganization· Family Medicine· Federal Way, WA
Family Medicine in Federal Way, Washington, registered in NPPES in January 2021. The authorized official on file is Kristyn Dice, Contracting Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1699364455 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 15, 2021 |
| Last updated in NPPES | Jul 13, 2023 |
| Certified by provider | Jul 29, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Physician Assistant | 363A00000X | — | — |
| Nurse Practitioner, Family | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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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