KHAMPHOUCANH SOUTHISOMBATH (NPI# 1114316734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114316734 |
| Entity Type | Individual |
| Full Name | KHAMPHOUCANH SOUTHISOMBATH |
| Credential | M.D. |
| Practice Address |
4400 37th Ave S Seattle WA 98118-1609 |
| Mailing Address |
1200 12th Ave S Ste 901 Seattle WA 98144-2712 |
| Practice Telephone | 2064616957 |
| Practice Fax Number | 2064617810 |
| Mailing Telephone | (206) 548-3114 |
| Mailing Fax Number | 2067626355 |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2017-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD60658344 | WA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | A133492 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1114316734 | 05 |
| Street Address |
4400 37TH AVE S |
| City | SEATTLE |
| State | WA |
| Zip Code | 98118-1609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740265735 | Timothy James Joos | Internal Medicine | 4400 37th Ave S, Seattle, WA 98118-1609 | 2005-12-13 |
| 1457868028 | Emma Hickey Spohn | Registered Nurse | 4400 37th Ave S, Seattle, WA 98118-1609 | 2018-01-04 |
| 1780113985 | Paul James Kunkel | Registered Nurse | 4400 37th Ave S, Seattle, WA 98118-1609 | 2017-06-09 |
| 1841728151 | Gabriela Boyle | Registered Nurse | 4400 37th Ave S, Seattle, WA 98118-1609 | 2017-05-31 |
| 1366970675 | Elizabeth Hertz-wahl | Registered Nurse | 4400 37th Ave S, Seattle, WA 98118-1609 | 2017-05-31 |
| 1497283725 | Rachel Emmick Moore | Registered Nurse | 4400 37th Ave S, Seattle, WA 98118-1609 | 2017-05-31 |
| 1932637311 | Erika Linn Fardig | Registered Nurse | 4400 37th Ave S, Seattle, WA 98118-1609 | 2017-05-30 |
| 1144758632 | Van Dinh Nguyen | Registered Nurse | 4400 37th Ave S, Seattle, WA 98118-1609 | 2017-05-26 |
| 1407384100 | Fiona Lynne Smith | Registered Nurse | 4400 37th Ave S, Seattle, WA 98118-1609 | 2017-05-25 |
| 1760910574 | Paula Kett | Registered Nurse | 4400 37th Ave S, Seattle, WA 98118-1609 | 2017-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386102812 | Psjh Pllc | Pharmacy | 3828 S Graham St Unit B, Seattle, WA 98118 | 2019-03-04 |
| 1912463670 | Hillman City Medical Pllc | Family Medicine | 3828 S Graham St Suite A, Seattle, WA 98118 | 2019-02-18 |
| 1992287650 | Valentina Komarova | Massage Therapist | 4321 S Webster St Unit D, Seattle, WA 98118 | 2018-08-29 |
| 1750884672 | Ka Hei Cheuk | Behavior Technician | 3815 S Othello Street, Suite 100 Box 361, Seattle, WA 98118 | 2018-03-16 |
| 1285150904 | Crystal N White | Counselor | 3815 S Othello St Suite 100 #317, Seattle, WA 98118 | 2017-08-15 |
| 1346775327 | Anya Lisha Andre | Student in an Organized Health Care Education/Training Program | 9245 Rainier Avenue South, Seattle, WA 98118 | 2017-04-27 |
| 1710334552 | Emeka Titus Okoye | Durable Medical Equipment & Medical Supplies | 4529 S. Henderson Street, #7, Seattle, WA 98118 | 2016-05-23 |
| 1104202191 | Elizabeth Kittay | Acupuncturist | 5224 Wilson Avenue South, Suite 202, Seattle, WA 98118 | 2015-08-03 |
| 1194129601 | Heather Vargas-lyon | Massage Therapist | 8338 Wolcott Ave S, Seattle, WA 98118 | 2014-10-13 |
| 1487069878 | Tamikia Jones | Massage Therapist | 9260 57th Ave S, Seattle, WA 98118 | 2014-06-25 |
| Find all providers in zip 98118 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114540457 | Country Doctor Community Clinic | Family Medicine | 2410 E Cherry St, Seattle, WA 98122-4832 | 2020-05-21 |
| 1407476500 | Charles C. Falzon, Md, Pllc | Family Medicine | 24 Roy St # 359, Seattle, WA 98109-4018 | 2020-04-20 |
| 1669028635 | Seattle World School Health Center | Family Medicine | 1700 E Union St, Seattle, WA 98122-4140 | 2019-08-14 |
| 1891350377 | Kaiser Foundation Health Plan of Washington | Family Medicine | 210 9th Ave N, Seattle, WA 98109-5120 | 2019-05-09 |
| 1619436029 | Galilea Medical Group, Pa | Family Medicine | 7527 42nd Ave Ne, Seattle, WA 98115-5101 | 2019-03-15 |
| 1912463670 | Hillman City Medical Pllc | Family Medicine | 3828 S Graham St Suite A, Seattle, WA 98118 | 2019-02-18 |
| 1740769868 | Oasis Medical Group, P.C. | Family Medicine | 301 Union St Unit 21502, Seattle, WA 98111-1623 | 2018-08-09 |
| 1316453608 | William Curchin | Family Medicine | 904 7th Ave Fl 9, Seattle, WA 98104-1132 | 2017-12-21 |
| 1871020933 | Seattle Sports & Regenerative Medicine | Family Medicine | 1000 Dexter Ave N Ste 300, Seattle, WA 98109-3579 | 2017-05-18 |
| 1790210847 | Christina Choung | Family Medicine | 211 Pike St Fl 8, Seattle, WA 98101-2107 | 2017-04-26 |
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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.