TOTEM LAKE PEDIATRICS (NPI# 1376706028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376706028 |
| Entity Type | Organization |
| Organization Name | TOTEM LAKE PEDIATRICS |
| Practice Address |
13128 Totem Lake Blvd Ne Ste 105 Kirkland WA 98034-2953 |
| Practice Telephone | 4258994570 |
| Mailing Telephone | 4258994570 |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-02 |
| Authorized Official Name | DR. FIROZ IBRAHIM (OWNER) |
| Authorized Official Telephone | 4258994570 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | MD00029356 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1078922 | 05 |
| Street Address |
13128 TOTEM LAKE BLVD NE STE 105 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-2953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669588240 | Firoz Ibrahim | Pediatrics | 13128 Totem Lake Blvd Ne Ste 105, Kirkland, WA 98034-2953 | 2006-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831558055 | Eastside Women's Health Center | Clinic/Center | 13128 Totem Lake Boulevard Ne, #204, Kirkland, WA 98034 | 2016-02-16 |
| 1376825802 | Comprehensive Natural Medicine | Clinic/Center | 11821 Ne 128th Street, Suite H, Kirkland, WA 98034 | 2011-09-10 |
| 1225641152 | Marina Park Plastics, Pllc | Clinic/Center | 16 Central Way, Kirkland, WA 98033-6115 | 2020-08-29 |
| 1730653312 | Novo Life Counseling | Clinic/Center | 10512 Ne 68th St Ste 101, Kirkland, WA 98033-7062 | 2019-01-16 |
| 1962892521 | Evergreen Health | Clinic/Center | 12040 Ne 128th St, Evergreenhealth Ms-31, Kirkland, WA 98034-3013 | 2015-02-03 |
| 1629336847 | Eye and Contact Lens Center Ps | Clinic/Center | 601 Market St, Kirkland, WA 98033-5422 | 2012-04-25 |
| 1780831917 | Proactive Nutrition, LLC | Clinic/Center | 13008 Ne 125th Way, Kirkland, WA 98034-7726 | 2008-08-19 |
| 1316166754 | Washington Sports Medicine Institute, LLC | Clinic/Center | 12707 120th Ave Ne, Suite 100, Kirkland, WA 98034-7500 | 2007-04-24 |
| 1932243490 | Professional Chiropractic Services Ps | Clinic/Center | 9750 Ne 120th Pl, Kirkland, WA 98034-4282 | 2007-02-17 |
| 1972619906 | Nadeshiko Clinic | Clinic/Center | 10827 Ne 68th St, Ste E, Kirkland, WA 98033-4000 | 2006-08-22 |
| Find all providers in KIRKLAND | ||||
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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.