CREEKSIDE SLEEP MEDICINE CENTER PLLC (NPI# 1184841256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184841256 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE SLEEP MEDICINE CENTER PLLC |
| Practice Address |
1380 112th Ave Ne #307 Bellevue WA 98004-3759 |
| Practice Telephone | 4252782250 |
| Practice Fax Number | 4255625885 |
| Mailing Telephone | 4252782250 |
| Mailing Fax Number | 4255625885 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2012-12-13 |
| Authorized Official Name | MRS. TERESA E. JACOBS (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4252782250 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
602620178 | WA | Ambulatory Health Care Facilities |
| Y | 207QS1201X |
Family Medicine Specialization: Sleep Medicine |
WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | UBI | 602620178 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154667475 | Creekside Sleep Medicine Center Pllc | Internal Medicine | 1380 112th Ave Ne, #307, Bellevue, WA 98004-3759 | 2012-12-13 |
| 1134464993 | Creekside Sleep Medicine Center Pllc | Internal Medicine | 1380 112th Ave Ne Ste 307, Bellevue, WA 98004-3759 | 2012-12-05 |
| Street Address |
1380 112TH AVE NE #307 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-3759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164473914 | Mandana Ahmadian | Internal Medicine | 1380 112th Ave Ne, Suite 205, Bellevue, WA 98004-3759 | 2006-05-15 |
| 1841623691 | Medical Arts Associates, P.s. | Non-Pharmacy Dispensing Site | 1380 112th Ave Ne, Suite 100, Bellevue, WA 98004-3759 | 2013-08-15 |
| 1154667475 | Creekside Sleep Medicine Center Pllc | Internal Medicine | 1380 112th Ave Ne, #307, Bellevue, WA 98004-3759 | 2012-12-13 |
| 1942513569 | Gary M. Burt | Dentist | 1380 112th Ave Ne, Suite 203, Bellevue, WA 98004-3759 | 2010-07-24 |
| 1154641975 | Shubh Ayengar | Family Medicine | 1380 112th Ave Ne, Suite #307, Bellevue, WA 98004-3759 | 2010-06-03 |
| 1164602256 | Gratia Mccallin Huxley | Nurse Practitioner | 1380 112th Ave Ne, #100, Bellevue, WA 98004-3759 | 2007-11-06 |
| 1245302215 | Marie E. Grohman | Family Medicine | 1380 112th Ave Ne, #100, Bellevue, WA 98004-3759 | 2006-11-15 |
| 1174695159 | Carla S Cohen | Psychologist | 1380 112th Ave Ne, Ste 101, Bellevue, WA 98004-3759 | 2006-11-14 |
| 1063522977 | Carol Ann Hedden Hackett | Family Medicine | 1380 112th Ave Ne, Ste #100, Bellevue, WA 98004 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 207QS1201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sleep Medicine |
| A Family Medicine Physician who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. |
| Notes: Source: American Academy of Sleep Medicine, 2008, www.aasm.org [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770877094 | Reuben D. Walia | Family Medicine | 1100 112th Ave Ne Ste 320, Bellevue, WA 98004 | 2011-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013264688 | La Cambra Co | Family Medicine | 7205 Martin Way E, Ste A-69, Olympia, WA 98516-5555 | 2012-08-13 |
| 1619057189 | Jessela D. Tan | Family Medicine | 1615 Delaware St, Longview, WA 98632-2367 | 2006-10-17 |
Please comment or provide details below to improve the information on CREEKSIDE SLEEP MEDICINE CENTER PLLC.
| 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.