WESTERN WASHINGTON MEDICAL GROUP, INC PS (NPI# 1093933491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093933491 |
| Entity Type | Organization |
| Organization Name | WESTERN WASHINGTON MEDICAL GROUP, INC PS |
| Other Organization Name | WESTERN WA MEDICAL GROUP DEPT OF RHEUMATOLOGY |
| Practice Address |
1330 Rockefeller Ave Ste 330 Everett WA 98201 |
| Mailing Address |
1728 W Marine View Dr Ste 110 Everett WA 98201-2094 |
| Practice Telephone | 4252528375 |
| Practice Fax Number | 4252528364 |
| Mailing Telephone | 4252594041 |
| Mailing Fax Number | 4252526642 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2018-07-17 |
| Authorized Official Name | MS. VICKI MCGINNIS (PRIVACY OFFICER) |
| Authorized Official Telephone | 4252594041 |
| Is Organization Subpart | Y |
| Parent Organization Name | WESTERN WASHINGTON MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
601474013 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | LABOR & INDUSTRY | 0141951 | 01 |
| WA | 7103641 | 05 | |
| WA | RAILROAD MEDICARE | DC9098 | 01 |
| Other Name | Type Code |
|---|---|
| Western Wa Medical Group Dept of Rheumatology | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1330 Rockefeller Ave Ste 330, Everett, WA 982011676 | 4252528375 | 4252528364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023236528 | Western Washington Medical Group, Inc Ps | Internal Medicine | 4225 Hoyt Ave Ste A, Everett, WA 98203-2351 | 2007-04-23 |
| 1649498049 | Western Washington Medical Group, Inc Ps | Family Medicine | 4225 Hoyt Ave Ste B, Everett, WA 98203-2351 | 2007-04-23 |
| 1932327335 | Western Washington Medical Group, Inc Ps | Podiatrist | 3202 Colby Ave Ste E, Everett, WA 98201-4324 | 2007-04-23 |
| 1326266727 | Western Washington Medical Group, Inc Ps | Psychologist | 3525 Colby Ave Ste 200, Everett, WA 98201-4782 | 2007-04-23 |
| 1538387931 | Western Washington Medical Group, Inc Ps | Urology | 4310 Colby Ave Ste 203, Everett, WA 98203-2338 | 2007-04-23 |
| 1417175811 | Western Washington Medical Group, Inc Ps | Internal Medicine | 1330 Rockefeller Ave Ste 450, Everett, WA 98201-1677 | 2007-04-23 |
| 1831238443 | Western Washington Medical Group, Inc Ps | Spec/Tech, Pathology | 6825 216th St Sw Ste E, Lynnwood, WA 98036-7379 | 2007-02-06 |
| 1003809229 | Western Washington Medical Group, Inc Ps | Clinic/Center | 3501 Shelby Rd, Suite B, Lynnwood, WA 98087-3599 | 2005-08-23 |
| 1538606413 | Western Washington Medical Group, Inc Ps | Internal Medicine | 1909 214th St Se, Suite 211, Bothell, WA 98021-4412 | 2017-01-30 |
| 1568916682 | Western Washington Medical Group, Inc Ps | Psychiatry & Neurology | 12728 19th Ave Se, Suite 300, Everett, WA 98208-6526 | 2016-08-05 |
| Street Address |
1330 ROCKEFELLER AVE STE 330 |
| City | EVERETT |
| State | WA |
| Zip Code | 98201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902024300 | Western Washington Medical Group, Inc Ps | Internal Medicine | 1330 Rockefeller Ave Ste 330, Everett, WA 98201-1676 | 2007-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306471867 | Shannon Michelle Dewald | Registered Nurse | D8s 1700 13th St, Everett, WA 98201 | 2020-03-05 |
| 1578123113 | Precious Medicial Spa, LLC | Registered Nurse | 1728 W. Marine View Dr Suite 212, Everett, WA 98201 | 2019-06-17 |
| 1508429796 | Alix Deschain | Counselor | 2801 Broadway, Everett, WA 98201 | 2019-04-15 |
| 1811457534 | Khushboo Patel | Pharmacist | 1330 Rockefeller Ave Ste 150, Everett, WA 98201 | 2019-03-20 |
| 1164991188 | Grace Talbot Davis | Registered Nurse | 2601 Summit Avenue, Bldg. C, Everett, WA 98201 | 2018-11-20 |
| 1063924603 | Tracy Sisk | Counselor | 3120 Colby Ave, 502, Everett, WA 98201 | 2017-11-03 |
| 1710403126 | Michelle Durham | Counselor | 3322 Boadway Fl 2, Everett, WA 98201 | 2017-08-17 |
| 1861927949 | Melanie Schmidt | Counselor | 2610 Westmore Ave, Everett, WA 98201 | 2017-04-26 |
| 1518413327 | Joseph Madson Dmd Pllc | Clinic/Center | 3802 Colby Ave, 4th Floor, Everett, WA 98201 | 2016-08-31 |
| 1043683162 | Jennifer Adams | Counselor | 1511 26th St, Everett, WA 98201 | 2015-11-11 |
| Find all providers in zip 98201 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| 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 |
|---|---|---|---|---|
| 1720086168 | Louie E Tsiktsiris | Internal Medicine | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2005-07-11 |
| 1386740355 | Jonathan Witte | Internal Medicine | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2006-09-16 |
| 1902901309 | Thuc Nguyen | Internal Medicine | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2006-09-13 |
| 1447355813 | Shaila Gala | Internal Medicine | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2006-09-13 |
| 1043315534 | Cathy Fritchen | Internal Medicine | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2006-09-13 |
| 1306853239 | Shawn L Slack | Internal Medicine | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2006-08-02 |
| 1972520872 | Karin Schmitt | Internal Medicine | 3218 Nassau St, Everett, WA 98201-4139 | 2006-07-16 |
| 1215977897 | Andrew S Sohn | Internal Medicine | 1330 Rockefeller Ave, Suite 330, Everett, WA 98201-1684 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437410354 | Jeonghun Moon | Internal Medicine | 4033 Talbot Rd S Ste 440, Renton, WA 98055-5767 | 2012-06-06 |
| 1356571087 | Christopher C. Wright | Internal Medicine | 105 W 8th Ave Ste 6080, Spokane, WA 99204-2313 | 2009-07-15 |
| 1508094707 | Daniel Jaeung Kim | Internal Medicine | 11311 Bridgeport Way Sw Ste 100, Lakewood, WA 98499-3096 | 2009-06-25 |
| 1962623959 | Wayne J Wallis | Internal Medicine | 2339 Federal Ave E, Seattle, WA 98102-4031 | 2007-05-01 |
| 1639399546 | Robert Lee Johnson | Internal Medicine | 1735 W Sunn Fjord Ln, Apartment I-107, Bremerton, WA 98312-5327 | 2007-04-26 |
| 1750433546 | Lisa Vasanth | Internal Medicine | 700 Ne 87th Ave # 330, Vancouver, WA 98664-1913 | 2007-01-18 |
| 1225196215 | John Flint Dickson | Internal Medicine | 714 Bellevue Ave East, #401, Seatlle, WA 98102-5990 | 2006-12-04 |
| 1659445260 | Janice Gupta | Internal Medicine | 515 Minor Avneue, Seattle, WA 98104 | 2006-11-17 |
| 1336218171 | Philip J Mease | Internal Medicine | 1101 Madison St Ste 1000, Seattle, WA 98104-3556 | 2006-11-07 |
| 1982781225 | Immune Disease Treatment Services Pllc | Internal Medicine | 14100 Se 36th St Ste 105, Bellevue, WA 98006-1657 | 2006-11-01 |
| Find all providers with the same taxonomy | ||||
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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.