Organization
THE POLYCLINIC PLLC
Active
Other names
Optum Broadway Endoscopy ASC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG PEPIN (CEO)
(206) 329-1760
Entity
Organization
Contact information
Practice address
1145 BROADWAY, SEATTLE, WA 98122-4201
(206) 860-4522
(206) 860-2292
Mailing address
1145 BROADWAY, SEATTLE, WA 98122-4201
(206) 860-4522
(206) 860-2292
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
178010389
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490001317
RAILROAD MEDICARE PIN
WA
05
—
7031644
—
WA
Enumeration date
09/12/2006
Last updated
12/29/2025
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