WESTERN WASHINGTON CARDIOLOGY TR (NPI# 1114217510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114217510 |
| Entity Type | Organization |
| Organization Name | WESTERN WASHINGTON CARDIOLOGY TR |
| Other Organization Name | WESTERN WASHINGTON CARDIOLOGY |
| Practice Address |
12728 19th Ave Se Suite 200 Everett WA 98208-6526 |
| Practice Telephone | 4252252700 |
| Practice Fax Number | 4252252790 |
| Mailing Telephone | 4252252700 |
| Mailing Fax Number | 4252252790 |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2011-04-19 |
| Authorized Official Name | CHARLES WILLIAM SCHNEIDER (PRES/CEO) |
| Authorized Official Telephone | 2063681700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Western Washington Cardiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477847606 | Western Washington Cardiology Tr | Internal Medicine | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2011-06-06 |
| Street Address |
12728 19TH AVE SE SUITE 200 |
| City | EVERETT |
| State | WA |
| Zip Code | 98208-6526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780643973 | Jessica Susan Webb | Nurse Practitioner | 12728 19th Ave Se, Suite 300, Everett, WA 98208-6526 | 2006-03-17 |
| 1366927253 | Victoria Leona Longstreth | Nurse Practitioner | 12728 19th Ave Se, Everett, WA 98208-6526 | 2018-09-26 |
| 1568916682 | Western Washington Medical Group, Inc Ps | Psychiatry & Neurology | 12728 19th Ave Se, Suite 300, Everett, WA 98208-6526 | 2016-08-05 |
| 1851710495 | Western Washington Medical Group | Pharmacist | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2014-04-10 |
| 1457793390 | Bariatric Surgery Clinic Trust | Surgery | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2013-07-19 |
| 1093064263 | Evelyn Woods | Dietitian, Registered | 12728 19th Ave Se, Suite 300, Everett, WA 98208-6526 | 2012-09-04 |
| 1568747012 | Jason Anthony Talavera | Internal Medicine | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2011-10-17 |
| 1477847606 | Western Washington Cardiology Tr | Internal Medicine | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2011-06-06 |
| 1770727307 | Jillian K Hamel | Nurse Practitioner | 12728 19th Ave Se, Ste 200, Everett, WA 98208-6526 | 2009-04-27 |
| 1447423017 | Andrea Vitello | Internal Medicine | 12728 19th Ave Se, Everett, WA 98208-6526 | 2008-04-03 |
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| 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 |
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| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1558317651 | Sanjeev Garhwal | Internal Medicine | 12728 19th Avenue Se, Suite 200, Everett, WA 98208-6526 | 2006-05-26 |
| 1417219874 | Joshua Schilling | Internal Medicine | 12728 19th Ave Se Ste 200, Everett, WA 98208 | 2012-06-12 |
| 1316209851 | Paula Marmont | Internal Medicine | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2012-06-11 |
| 1568747012 | Jason Anthony Talavera | Internal Medicine | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2011-10-17 |
| 1184912636 | Naseem Afrasiabi Ghazanfari | Internal Medicine | 2930 Maple St, Everett, WA 98201-3832 | 2011-07-19 |
| 1477847606 | Western Washington Cardiology Tr | Internal Medicine | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2011-06-06 |
| 1699094359 | Vivek Bhatia | Internal Medicine | 1330 Rockefeller Ave, Ste 310, Everett, WA 98201-1684 | 2010-05-20 |
| 1609005370 | Sirikarn Napan | Internal Medicine | 1330 Rockefeller Ave, Ste 310, Everett, WA 98201-1684 | 2009-07-02 |
| 1396906129 | Cynthia A Warner | Internal Medicine | 1330 Rockefeller Ave Ste 310, Everett, WA 98201 | 2008-06-24 |
| 1841418241 | Western Washington Medical Group, Inc Ps | Internal Medicine | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2007-04-23 |
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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.