DERRICK SOONG (NPI# 1275946519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275946519 |
| Entity Type | Individual |
| Full Name | DERRICK SOONG |
| Practice Address |
100 Ne Gilman Blvd Issaquah WA 98027-2925 |
| Practice Telephone | 4255578000 |
| Practice Fax Number | 4255578014 |
| Mailing Telephone | 4255578000 |
| Mailing Fax Number | 4255578014 |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2017-12-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD60777389 | WA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
100 NE GILMAN BLVD |
| City | ISSAQUAH |
| State | WA |
| Zip Code | 98027-2925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043214596 | Virginia Mason Medical Center | Pharmacy | 100 Ne Gilman Blvd, Issaquah, WA 98027-2925 | 2005-06-10 |
| 1932658564 | Anna Hancock | Physician Assistant | 100 Ne Gilman Blvd, Issaquah, WA 98027 | 2016-09-23 |
| 1609252063 | Jeffrey Selbig | Registered Nurse | 100 Ne Gilman Blvd, Issaquah, WA 98027-2925 | 2015-08-07 |
| 1548667330 | Olga Klachkovich | Psychiatry & Neurology | 100 Ne Gilman Blvd, Issaquah, WA 98027-2925 | 2014-11-23 |
| 1912339276 | Machiko Mcclave | Physical Therapist | 100 Ne Gilman Blvd, Issaquah, WA 98027 | 2013-08-08 |
| 1164714671 | Sara May | Student in an Organized Health Care Education/Training Program | 100 Ne Gilman Blvd, Issaquah, WA 98027-2925 | 2011-05-03 |
| 1932342649 | Jessica Lynn Ebberson | Pediatrics | 100 Ne Gilman Blvd, Issaquah, WA 98027-2925 | 2009-04-10 |
| 1578723326 | Connie June Chen | Ophthalmology | 100 Ne Gilman Blvd, Issaquah, WA 98027-2925 | 2008-06-16 |
| 1023217734 | Alice J. Kim | Internal Medicine | 100 Ne Gilman Blvd, Issaquah, WA 98027-2925 | 2007-07-12 |
| 1245448935 | Alvin Ngan | Podiatrist | 100 Ne Gilman Blvd, Issaquah, WA 98027-2925 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780281840 | Cascade Hand & Orthopedic Rehab, Inc. | Clinic/Center | 1301 4th Avenue Nw, Suite 200, Issaquah, WA 98027 | 2020-10-01 |
| 1700494630 | Genevieve S Ward | Counselor | 22500 Se 64th Place, Building G, Suite 150, Issaquah, WA 98027 | 2020-07-16 |
| 1891338604 | Amy Mezulis | Psychologist | 1740 Nw Maple St. #210, Issaquah, WA 98027 | 2019-10-24 |
| 1578055083 | Vivian Yu-en Hsiao | Physical Therapist | 1301 4th Ave Nw Ste 300, Issaquah, WA 98027 | 2018-05-31 |
| 1831698000 | Peter James Carlson | Physical Therapist | 22500 Se 64th Place, Building G, Suite 115, Issaquah, WA 98027 | 2018-02-02 |
| 1902323553 | David Robert Primrose | Dentist | 600 Nw Gilman Blvd Ste B, Issaquah, WA 98027 | 2017-08-24 |
| 1083135446 | Tara Rose | Massage Therapist | 680 Nw Gilman Blvd., Ste. A, Issaquah, WA 98027 | 2017-07-06 |
| 1295276194 | Amy Davenport | Occupational Therapist | 1871 Nw Gilman Blvd #2, Issaquah, WA 98027 | 2017-03-13 |
| 1942751771 | Krista L Gibbons | Counselor | 1700 Nw Blvd, Suite #200, Issaquah, WA 98027 | 2016-10-17 |
| 1376903237 | Kari Wathen Torres | Occupational Therapist | 710 Nw Juniper St Ste 100, Issaquah, WA 98027 | 2016-03-03 |
| Find all providers in zip 98027 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700057817 | Leo E Ho | Pediatrics | 635 Nw Datewood Dr, Issaquah, WA 98027-2627 | 2008-03-17 |
| 1477626125 | Pediatric Associates, Inc., P.s. Dba Allegro Pediatrics | Pediatrics | 1011 Ne High Street, Suite #200, Issaquah, WA 98029 | 2006-11-17 |
| 1417026030 | Christen B Oskouian | Pediatrics | 6520 226th Pl Se Ste 100, Issaquah, WA 98027-7365 | 2006-11-07 |
| 1720340540 | Jacqueline Le Hunziker | Pediatrics | 6520 226th Pl Se Ste 100, Issaquah, WA 98027-7365 | 2012-06-08 |
| 1184957367 | Tiffany Lynne Herr | Pediatrics | 751 Ne Blakely Dr Ste 5010, Issaquah, WA 98029-6201 | 2009-09-07 |
| 1932342649 | Jessica Lynn Ebberson | Pediatrics | 100 Ne Gilman Blvd, Issaquah, WA 98027-2925 | 2009-04-10 |
| 1720242944 | Michelle Marquardt Cole | Pediatrics | 751 Ne Blakely Dr, Issaquah, WA 98029-6201 | 2008-07-16 |
| 1295916559 | David Ege | Pediatrics | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2483 | 2007-11-15 |
| 1881875151 | Sandra Sjoberg | Pediatrics | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2483 | 2007-11-15 |
| 1649316266 | Issaquah Medical Group | Pediatrics | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2483 | 2007-01-30 |
| Find all providers in ISSAQUAH | ||||
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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.