NORTHWEST WEIGHT LOSS SURGERY, PLLC (NPI# 1023069747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023069747 |
| Entity Type | Organization |
| Organization Name | NORTHWEST WEIGHT LOSS SURGERY, PLLC |
| Practice Address |
125 130th St Se First Floor Everett WA 98208-6400 |
| Mailing Address |
125 130th St Se Everett WA 98208-6400 |
| Practice Telephone | 4253852263 |
| Practice Fax Number | 4253858476 |
| Mailing Telephone | 4253414800 |
| Mailing Fax Number | 4253858476 |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2012-03-21 |
| Authorized Official Name | MRS. GAIA E LUKEVICH (ADMINISTRATOR) |
| Authorized Official Telephone | 4253852263 |
| Authorized Official Credential | RN, BSN, RNFA, C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 602225209 | WA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | STATE LICENSE BUSINESS ID | 602225209 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487693800 | Northwest Weight Loss Surgery, Pllc | Clinic/Center | 125 130th St Se, First Floor, Everett, WA 98208-6400 | 2006-06-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | NORTHWEST WEIGHT LOSS SURGERY, PLLC | 701 Pike St # 1700, Seattle, WA 98101 |
| Street Address |
125 130TH ST SE FIRST FLOOR |
| City | EVERETT |
| State | WA |
| Zip Code | 98208-6400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467440693 | Jessie H. Ahroni | Nurse Practitioner | 125 130th St Se, Everett, WA 98208-6400 | 2005-10-12 |
| 1972075687 | Nicole Crotty | Dietitian, Registered | 125 130th St Se, Everett, WA 98208-6401 | 2018-12-19 |
| 1669953147 | Andrea L Mcdonald | Health Educator | 125 130th St Se, Everett, WA 98208-6401 | 2018-08-23 |
| 1497264311 | Ginny George | Nurse Practitioner | 125 130th St Se, Everett, WA 98208 | 2017-09-22 |
| 1336501865 | Amelia Mckee Ferrel | Dietitian, Registered | 125 130th St Se, 1st Floor, Everett, WA 98208-6401 | 2016-03-23 |
| 1659737658 | Christine Kreins | Dietitian, Registered | 125 130th St Se, First Floor, Everett, WA 98208-6401 | 2016-01-06 |
| 1609254028 | Andrea Murphy | Registered Nurse | 125 130th St Se, Everett, WA 98208-6401 | 2015-05-18 |
| 1659649838 | Sarah Cameron Ouellette | Dietitian, Registered | 125 130th St Se, 1st Floor, Everett, WA 98208-6401 | 2011-12-02 |
| 1124341789 | Kuo Chiang Yee | Acupuncturist | 125 130th St Se, #202, Neuroscience Medical Center, Everett, WA 98208 | 2010-03-10 |
| 1831343573 | Kathy J Winks | Registered Nurse | 125 130th St Se, Everett, WA 98208-6401 | 2008-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790270296 | Kenneth Britt Dyer | Registered Nurse | 10333 19th Ave, Se, Ste #109, Everett, WA 98208 | 2018-06-27 |
| 1518482215 | Glacier Peak Healthcare, Inc. | Home Health | 10530 19th Ave Se Ste 201, Everett, WA 98208 | 2017-08-03 |
| 1114454865 | Aliza Kreisman | Registered Nurse | 11020 19th Avenue Se, Kaiser Permanente of Washington Seattle Care Clinic, Everett, WA 98208 | 2017-05-12 |
| 1902269418 | Clay Eakin | Counselor | 2732 Grand Evenue, Everett, WA 98208 | 2016-04-01 |
| 1467810259 | Elizabeth Anne Powley | Marriage & Family Therapist | 1920 100th Street Southeast, Bld C3, Everett, WA 98208 | 2016-02-08 |
| 1659745842 | Andrea Rose Bedlington | Pharmacist | 11407 33rd Dr. Se, Everett, WA 98208 | 2015-11-25 |
| 1396123865 | Sound Surgeons Pllc | Clinic/Center | 125 130th Street Se, 1st Floor, Everett, WA 98208 | 2015-05-15 |
| 1831576537 | Chris Sturgeon | Counselor | 10102 Meridian Ave, Everett, WA 98208 | 2015-05-01 |
| 1982011128 | James M Lee | Physical Therapist | 10821 19th Ave Se Ste 102, Everett, WA 98208 | 2014-07-21 |
| 1972937357 | Ronald Tracy | Dentist | 10315 19th Avenue Se Suite 110, Everett, WA 98208 | 2013-08-21 |
| Find all providers in zip 98208 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548643224 | Zackery A Robinson | Specialist | 3003 W Casino Rd Bldg 40.421, Everett, WA 98204-1910 | 2015-06-30 |
| 1871972380 | Karissa Kayleen Councill-trinidad | Specialist | 3223 Tulalip Ave, Everett, WA 98201-4155 | 2015-05-29 |
| 1629470422 | Betty Thorson | Specialist | 711 112th St Se Ste C, Everett, WA 98208-5283 | 2014-09-23 |
| 1942571880 | Alena A Klimenko | Specialist | 12811 8th- Ave W, Suite B-103, Everett, WA 98204 | 2012-01-24 |
| 1174829709 | Rebecca Lynn Morris | Specialist | 11614a 35th Ave Se, Everett, WA 98208-5306 | 2011-01-29 |
| 1083867428 | Susan Anne Helm | Specialist | 2020 Lake Heights Dr Apt M304, Everett, WA 98208-6061 | 2008-10-29 |
| 1205088622 | Anne E Miller | Specialist | 11619 31st Dr Se, Everett, WA 98208-6107 | 2008-10-16 |
| 1861655391 | Dana Bianchi | Specialist | 2320 Del Campo Dr, Everett, WA 98208-3405 | 2008-07-03 |
| 1962679217 | Reisa A. Cole | Specialist | 1902 120th Pl Se, Ste 102, Everett, WA 98208 | 2008-05-14 |
| 1326212390 | Holly Nicole Foor | Specialist | 181 Old Racetrack Rd, Everett, PA 15537-4572 | 2008-04-21 |
| Find all providers in EVERETT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.