PUGET SOUND GASTROENTEROLOGY, PLLC (NPI# 1033132956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033132956 |
| Entity Type | Organization |
| Organization Name | PUGET SOUND GASTROENTEROLOGY, PLLC |
| Other Organization Name | PUGET SOUND GASTROENTEROLOGY AT EDMONDS |
| Practice Address |
21600 Hwy 99 Suite 260 Edmonds WA 98026-8012 |
| Mailing Address |
Po Box 34888 Seattle WA 98124-1888 |
| Practice Telephone | 4257742650 |
| Practice Fax Number | 4257742643 |
| Mailing Telephone | 4259774620 |
| Mailing Fax Number | 4257459836 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2019-12-12 |
| Authorized Official Name | EUGENIO J HERNANDEZ (MANAGER) |
| Authorized Official Telephone | 7862053464 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1042580 | 05 | |
| WA | LABOR AND INDUSTRIES | 0037140 | 01 |
| Other Name | Type Code |
|---|---|
| Puget Sound Gastroenterology at Edmonds | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689646838 | Puget Sound Gastroenterology, Pllc | Clinical Medical Laboratory | 19000 33rd Ave W, Suite 230, Lynnwood, WA 98036-4751 | 2006-02-02 |
| 1386615912 | Puget Sound Gastroenterology, Pllc | Clinic/Center | 501 N 34th St, Suite 101, Seattle, WA 98103-8645 | 2006-01-31 |
| 1427185388 | Puget Sound Gastroenterology, Pllc | Clinical Medical Laboratory | 11800 Ne 128th St, Suite 100, Kirkland, WA 98034-7208 | 2007-02-27 |
| 1912929738 | Puget Sound Gastroenterology, Pllc | Internal Medicine | 16504 9th Ave Se, Suite 106, Mill Creek, WA 98012-6388 | 2006-07-24 |
| 1811914625 | Puget Sound Gastroenterology, Pllc | Clinic/Center | 21600 Hwy 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-16 |
| 1649212606 | Puget Sound Gastroenterology, Pllc | Clinical Medical Laboratory | 11027 Meridian Ave N, Suite 100, Seattle, WA 98133-1705 | 2006-06-12 |
| 1447212337 | Puget Sound Gastroenterology, Pllc | Clinic/Center | 11800 Ne 128th St, Suite 100, Kirkland, WA 98034-7208 | 2006-04-05 |
| 1720059348 | Puget Sound Gastroenterology, Pllc | Clinic/Center | 11027 Meridian Ave N, Suite 100, Seattle, WA 98133-1705 | 2006-01-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PUGET SOUND GASTROENTEROLOGY, PLLC | 9155 S Dadeland Blvd, Suite 1500, Miami, FL 33156-2740 |
| Street Address |
21600 HWY 99 SUITE 260 |
| City | EDMONDS |
| State | WA |
| Zip Code | 98026-8012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386636934 | David L Heard | Physical Medicine & Rehabilitation | 21600 Hwy 99, Suite 255, Edmonds, WA 98026-8012 | 2005-08-19 |
| 1669645172 | Children's Clinic of South Snohomish County, Ltd | Pediatrics | 21600 Hwy 99, Suite 290, Edmonds, WA 98026-8012 | 2008-04-04 |
| 1750471892 | Said Yaaqoubi | Specialist | 21600 Hwy 99, Siute150, Edmonds, WA 98026-8047 | 2006-10-12 |
| 1821012915 | Raymond Liu | Dentist | 21600 Hwy 99, Suite 100, Edmonds, WA 98026-8012 | 2006-07-26 |
| 1235150947 | Timothy E Little | Internal Medicine | 21600 Hwy 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-21 |
| 1174544712 | Jason I Schneier | Internal Medicine | 21600 Hwy 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-21 |
| 1811914625 | Puget Sound Gastroenterology, Pllc | Clinic/Center | 21600 Hwy 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-16 |
| 1912924739 | Jinfeng J Guo | Internal Medicine | 21600 Hwy 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-16 |
| 1275569980 | Druska L Salisbury-milan | Physician Assistant | 21600 Hwy 99, Suite 280, Edmonds, WA 98026-8012 | 2006-06-24 |
| 1982699393 | Agnes Wong | Pediatrics | 21600 Hwy 99, Suite 290, Edmonds, WA 98026-8012 | 2005-09-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833526 | Enas Hamid Albar | Student in an Organized Health Care Education/Training Program | 7500 212th Street S.w., Suite 205, Edmonds, WA 98026 | 2020-08-26 |
| 1215579453 | Kailey Anne Matulich | Technician | 21630 84th Ave W, Edmonds, WA 98026 | 2019-10-09 |
| 1154962124 | Steven M Weible | Technician | 21630 84th Ave, Edmonds, WA 98026 | 2019-10-01 |
| 1053767293 | Hyo Kyung Kim | Pharmacist | 22618 Hwy 99 Ste 109, Edmonds, WA 98026 | 2016-05-06 |
| 1679947956 | Lucilyn Lumio | Occupational Therapist | 21008 76th Avenue W, Edmonds, WA 98026 | 2015-11-24 |
| 1669844205 | Kathleen Schmitt | Pharmacist | 21601 76th Ave West, Edmonds, WA 98026 | 2015-10-22 |
| 1689087967 | Ronald Paul Meagher | Anesthesiology | 7305 173rd St Sw, Edmonds, WA 98026 | 2014-06-04 |
| 1598194342 | Allison Alberton | Surgery | 7315 212th St Sw Ste 201, Edmonds, WA 98026 | 2013-11-02 |
| 1356681019 | Tekle Zewolday Eysadik | Registered Nurse | 8102 - 226 St Sw, Edmonds, WA 98026 | 2013-02-18 |
| 1447557087 | Diane Taylor | Counselor | 20903 70th Ave W., Edmonds, WA 98026 | 2011-02-17 |
| Find all providers in zip 98026 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225090566 | Michelle J. Gottschlich | Internal Medicine | 21600 Highway 99, Suite 260, Edmonds, WA 98026-8012 | 2006-04-03 |
| 1932214384 | Lei Y Lim | Internal Medicine | 21600 Highway 99, Suite 260, Edmonds, WA 98026-8012 | 2006-08-19 |
| 1235150947 | Timothy E Little | Internal Medicine | 21600 Hwy 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-21 |
| 1831110451 | Gary N Dines | Internal Medicine | 21600 Highway 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-21 |
| 1184645707 | Robert G Chaffee | Internal Medicine | 21600 Highway 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-21 |
| 1174544712 | Jason I Schneier | Internal Medicine | 21600 Hwy 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-21 |
| 1912924739 | Jinfeng J Guo | Internal Medicine | 21600 Hwy 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-16 |
| 1265459135 | Cara K Debley | Internal Medicine | 21600 Highway 99, Suite 260, Edmonds, WA 98026-8012 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639618630 | Digestive Gi Care | Internal Medicine | 305 Sw Chkalov Dr, 111-140, Vancouver, WA 98683 | 2017-02-23 |
| 1407238173 | South Perry Endoscopy Pllc | Internal Medicine | 907 South Perry Street Suite 203, Spokane, WA 99202 | 2015-06-18 |
| 1316351430 | Mohammed M. Aboelsoud | Internal Medicine | 4545 Cordata Pkwy Ste 1b, Bellingham, WA 98226-7264 | 2014-06-17 |
| 1952721771 | Ling Guo | Internal Medicine | Kaiser Permanente Central Hospital Building, 126 16th Ave E, Seattle, WA 98112 | 2014-04-19 |
| 1881032423 | Richard Atwood Willson | Internal Medicine | 815 West Galer Street, Seattle, WA 98119 | 2013-06-05 |
| 1770833857 | Jonathan Alan Levant | Internal Medicine | 3201 Pacific Ave, Unit 1108, Tacoma, WA 98418-6907 | 2012-09-15 |
| 1841572724 | Kenneth Bruce Klein | Internal Medicine | 7470 Ne Manual Rd, Bainbridge Island, WA 98110-3032 | 2011-09-15 |
| 1972891505 | Gorav Kalra | Internal Medicine | 410 9th Ave, Seattle, WA 98104-2499 | 2011-07-18 |
| 1609163294 | Patrick John Laing | Internal Medicine | 301 W Poplar St Ste 210, Walla Walla, WA 99362-2800 | 2011-07-01 |
| 1194018366 | Hamid Habibi | Internal Medicine | 105 W 8th Ave Ste 6010, Spokane, WA 99204 | 2011-05-20 |
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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.