Healthcare Provider Details

I. General information

NPI: 1578435509
Provider Name (Legal Business Name): JOIVIVA PRIMARY CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 HILDEBRAND LN NE STE 102
BAINBRIDGE ISLAND WA
98110-2877
US

IV. Provider business mailing address

945 HILDEBRAND LN NE STE 102
BAINBRIDGE ISLAND WA
98110-2877
US

V. Phone/Fax

Practice location:
  • Phone: 206-745-2859
  • Fax: 206-451-5439
Mailing address:
  • Phone: 206-745-2859
  • Fax: 206-451-5439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE EDWARDS
Title or Position: OWNER
Credential: MD
Phone: 206-745-2859