Nina T Willow · Nina T Greenblatt · Family Medicine Physician

3927 Rucker Ave, Everett, WA 98201-4833

Overview

Nina T Willow is a Family Medicine Physician practicing in Everett, Washington. The National Provider Identifier (NPI) is #1225163322, which was assigned on February 22, 2007, and the registration record was last updated on April 3, 2026. The practitioner's main practice location is at 3927 Rucker Ave, Everett, WA 98201-4833; the contact telephone number is 4252599066. The primary taxonomy of Nina T Willow is Family Medicine Physician (207Q00000X). Nina T Willow is licensed to practice in the state of Washington (#MD00040151).

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Provider Information

NPI 1225163322
Entity Type Individual
Provider Name NINA T WILLOW
Other Name NINA T GREENBLATT
(Former Name)
Gender Female
Credential M.D.
Other Credential M.D.
Practice Address 3927 Rucker Ave
Everett
WA 98201-4833
Practice Telephone 4252599066
Mailing Address Po Box 5127
Everett
WA 98206-5127
Mailing Telephone 2068605414
Certification Date 2026-04-03
Enumeration Date 2007-02-22
Last Update Date 2026-04-03
Is Sole Proprietor N

Doctor and Clinician Information

PAC ID 8022101195
Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID
Full Name NINA T WILLOW
Medical School TUFTS UNIVERSITY SCHOOL OF MEDICINE
Primary Specialty FAMILY PRACTICE
Organization Legal Name KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
Address 201 16th Ave E
Seattle
WA 98112-5226

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y207Q00000XFamily MedicineMD00040151WA

Other Provider Identifiers

Other IdentifierIssuing StateIssuerIdentifier Type
8290082WAMEDICAID

Taxonomy Information

Primary Taxonomy

Code 207Q00000X
Taxonomy Family Medicine Physician
Classification Family Medicine
Grouping Allopathic & Osteopathic Physicians
Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

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Location Information

Street Address 3927 RUCKER AVE
City EVERETT
State WA
Zip Code 98201-4833
Country US

Providers in the same location

Provider NameAddressTaxonomyEnumeration Date
Shanna Emanuelson 3927 Rucker Ave, Everett, WA 98201-4833Occupational Therapist2022-07-26
Mary Oestreich · Mary Anderson 3927 Rucker Ave, Everett, WA 98201-4833Nurse Practitioner2019-07-15
Brendan Harrison 3927 Rucker Ave, Everett, WA 98201-4833Internal Medicine Physician2018-06-20
Tianyi Yu 3927 Rucker Ave, Everett, WA 98201-4833Physical Therapist2021-10-06
Yoon Jung Ra 3927 Rucker Ave, Everett, WA 98201-4833Acute Care Nurse Practitioner2018-11-14
Jessica Wai Teng Mau 3927 Rucker Ave, Everett, WA 98201-4833Nurse Practitioner2019-06-06
Holly Anne Bernstein 3927 Rucker Ave, Everett, WA 98201-4833Nurse Practitioner2020-08-12
Caitlin Vosburgh 3927 Rucker Ave, Everett, WA 98201-4833Nurse Practitioner2020-09-14
Graciela Varela 3927 Rucker Ave, Everett, WA 98201-4833Nurse Practitioner2019-07-10
Austen Lawrence 3927 Rucker Ave, Everett, WA 98201-4833Diagnostic Radiology Physician2017-04-28
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Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Max Martin Bispo 902 Pine St, Everett, WA 98201-1403Peer Specialist2025-10-01
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Kelligrace Pascua Hernandez 902 Pine St, Everett, WA 98201-1403Counselor2026-02-25
Hilina Tulu 1014 Hoyt Ave, Everett, WA 98201-1528Registered Nurse2026-02-07
Kathy Schalka Marvin 4001 Colby Ave, Everett, WA 98201Dentist2006-12-15
Amanda Lopez 902 Pine St, Everett, WA 98201-1403Addiction (Substance Use Disorder) Counselor2023-04-04
Sumaira Dawari 930 N Broadway, Everett, WA 98201-1409Physician Assistant2022-08-15
Gazelle Williams 2722 Colby Ave Suite 706, Everett, WA 98201Mental Health Counselor2014-11-14
Ajitha Kommalapati 1717 13th St, Everett, WA 98201-1621Hospitalist Physician2016-06-17
Chelsea Matteson 2735 10th St, Everett, WA 98201-1413Mental Health Counselor2015-12-16
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.