UROLOGIC NORTHWEST SURGEONS PS (NPI# 1265575336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265575336 |
| Entity Type | Organization |
| Organization Name | UROLOGIC NORTHWEST SURGEONS PS |
| Practice Address |
316 Martin Luther King Jr Way Suite 312 Tacoma WA 98405-4252 |
| Practice Telephone | 2533834404 |
| Practice Fax Number | 2532725177 |
| Mailing Telephone | 2533834404 |
| Mailing Fax Number | 2532725177 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-10-10 |
| Authorized Official Name | DR. FRANCIS YOUNG-JIN KIM (PRESIDENT) |
| Authorized Official Telephone | 2533834404 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | MD00040403 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 118074 | 05 |
| Street Address |
316 MARTIN LUTHER KING JR WAY SUITE 312 |
| City | TACOMA |
| State | WA |
| Zip Code | 98405-4252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144225780 | Laura Lynn Hershkowitz | Neuromusculoskeletal Medicine, Sports Medicine | 316 Martin Luther King Jr Way, #408, Tacoma, WA 98405-4252 | 2005-06-20 |
| 1295187573 | Amberkiah L Pomeroy | Audiologist | 316 Martin Luther King Jr Way, Suite 305, Tacoma, WA 98405-4252 | 2016-07-11 |
| 1083042816 | Jason Eric Legan | Physician Assistant | 316 Martin Luther King Jr Way, Tacoma, WA 98405-4252 | 2013-10-14 |
| 1386928216 | Craig A Rone Md Ps | Otolaryngology | 316 Martin Luther King Jr Way, # 305, Tacoma, WA 98405-4252 | 2011-10-11 |
| 1396076741 | Rebanta Kumar Chakraborty | Family Medicine | 316 Martin Luther King Jr Way, Tacoma, WA 98405-4252 | 2010-01-26 |
| 1477716850 | Jaime J Payne | Family Medicine | 316 Martin Luther King Jr Way, Tacoma, WA 98405-4252 | 2008-07-07 |
| 1205007424 | Christopher Cuevas Cuevas | Family Medicine | 316 Martin Luther King Jr Way, Suite 401, Tacoma, WA 98405-4252 | 2008-03-14 |
| 1710166129 | Sara J Diem | Physician Assistant | 316 Martin Luther King Jr Way, Tacoma, WA 98405-4252 | 2007-11-01 |
| 1629266093 | Sara A Waversveld | Podiatrist | 316 Martin Luther King Jr Way, #201, Tacoma, WA 98405-4252 | 2007-10-10 |
| 1215070297 | Francis Young-jin Kim | Urology | 316 Martin Luther King Jr Way, Suite 312, Tacoma, WA 98405-4252 | 2007-02-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
| 1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
| 1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
| 1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
| 1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
| 1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
| 1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
| 1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
| 1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
| 1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
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| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730447731 | Daniel Christian Sackman | Urology | 3124 South 19th St #c320, Tacoma, WA 98405-3011 | 2012-04-26 |
| 1073886438 | Peter John Minich | Urology | 3124 S 19th St Ste 240, Tacoma, WA 98405-2433 | 2012-02-15 |
| 1780909184 | Matthew Michael Banti | Urology | Urology Service Madigan Army Ctr, 9040 Jackson Ave, Tacoma, WA 98431-1100 | 2010-03-29 |
| 1942436886 | Charles Y Chang | Urology | 3124 S 19th St # 320, Tacoma, WA 98405-2433 | 2009-06-05 |
| 1649442682 | Patrick Shannon Mcdonough | Urology | Madigan Army Medical Center - Bldg 9040, Fitzsimmons Drive, Tacoma, WA 98431-0001 | 2008-03-31 |
| 1063525723 | Scott Paul Cuda | Urology | Madigan Army Medical Center 9040 Jackson Avenu, Tacoma, WA 98431-7282 | 2006-08-16 |
| 1306879366 | Jack Ryan Walter | Urology | 9040 Jackson Ave Mamc Urology, Tacoma, WA 98431 | 2006-07-09 |
| 1134472798 | Carolyn Anne Salter | Urology | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2012-10-19 |
| 1477839066 | Richard Johnston | Urology | 1708 Yakima Ave, Suite 310, Tacoma, WA 98405-5307 | 2011-10-26 |
| 1902137763 | Franciscan Medical Group | Urology | 1624 S I St, Ste 204, Tacoma, WA 98405-5016 | 2010-01-19 |
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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.