SOUTH SOUND MEDICAL GROUP, PLLC (NPI# 1285018432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285018432 |
| Entity Type | Organization |
| Organization Name | SOUTH SOUND MEDICAL GROUP, PLLC |
| Practice Address |
10116 Coachman Ln Se Olympia WA 98501-9731 |
| Practice Telephone | 3605568465 |
| Mailing Telephone | 3605568465 |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-09-23 |
| Authorized Official Name | JESSICA VAN FLEET-GREEN (OWNER/MD) |
| Authorized Official Telephone | 3605568465 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD60162757 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | NPI | 1679736318 | 01 |
| WA | 1679736318 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | SOUTH SOUND MEDICAL GROUP, PLLC | 10116 Coachman Ln Se, Olympia, WA 98501-9731 |
| Street Address |
10116 COACHMAN LN SE |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98501-9731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124651880 | Marie T Bendig | Counselor | 900 Fairview St Se, #b5, Olympia, WA 98501 | 2020-02-20 |
| 1205469970 | Thurston County Fire Protection Dist 6 | Ambulance | 8047 Normandy St. Se, Olympia, WA 98501 | 2020-02-20 |
| 1134768799 | Living Sound Therapeutic Services, Pllc | Counselor | 729 Devoe St Se, Olympia, WA 98501 | 2019-12-31 |
| 1336797273 | Sea-mar Community Health Center | Dentist | 6004 Capitol Ave Sw, Tumwater, WA 98501 | 2019-09-03 |
| 1093272841 | Eye Love Pllc | Optometrist | 3409 Capitol Blvd Se, Tumwater, WA 98501 | 2019-02-28 |
| 1356815062 | Kerri Wright | Marriage & Family Therapist | 208 Lee St Sw Ste 108, Tumwater, WA 98501 | 2019-01-15 |
| 1952881161 | Paige Gautreaux | Peer Specialist | 908 5th Avenue Se, Olympia, WA 98501 | 2018-08-16 |
| 1548773997 | Carla Van Dam | Psychologist | 2620 Rw Johnson Blvd Sw Suite 204, Tumwater, WA 98501 | 2017-11-08 |
| 1528577202 | Ronald John San Nicolas | Counselor | 1011 10th Ave, Olympia, WA 98501 | 2017-09-25 |
| 1063964187 | Emily Rapesak | Pharmacist | 500 Cleveland Ave Se, Tumwater, WA 98501 | 2016-10-25 |
| Find all providers in zip 98501 | ||||
| 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 |
|---|---|---|---|---|
| 1154974368 | Unruhly Medicine Pllc | Family Medicine | 1701 4th Ave E, Olympia, WA 98506-4533 | 2019-07-17 |
| 1104340405 | Sweet Medical Group, Pllc | Family Medicine | 8315 Normandy St Se, Olympia, WA 98504-0001 | 2017-07-28 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1710378229 | Mary Gibbons | Family Medicine | 7040 Puget Beach Rd Ne, Olympia, WA 98516-9158 | 2015-02-05 |
| 1588095749 | Coral Hilby | Family Medicine | 2520 Island Dr Nw, Olympia, WA 98502-9749 | 2013-12-12 |
| 1053756999 | Anna Maria A. Pletz | Family Medicine | 525 Lilly Rd Ne # 250, Pmg Sw Wa East Olympia Fam Med, Olympia, WA 98506-5101 | 2013-05-06 |
| 1811330673 | Eugen Sine Enterprises Inc | Family Medicine | 2121 Stillwater Ave Nw, Olympia, WA 98507 | 2013-04-11 |
| 1972877736 | Eric Richard Houghton | Family Medicine | 1832 Lakewood Cir Se, Olympia, WA 98501-4291 | 2012-02-25 |
| 1073828976 | Lacambra Services Inc | Family Medicine | 7205 Martin Way E, Suite A-69, Olympia, WA 98516-5555 | 2010-08-16 |
| 1376872820 | Jan Peter Vleck | Family Medicine | 2415 Heritage Ct Sw, Olympia, WA 98502-6031 | 2009-12-11 |
| Find all providers in OLYMPIA | ||||
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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.