WESTERN WASHINGTON MEDICAL GROUP, INC PS (NPI# 1538606413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538606413 |
| Entity Type | Organization |
| Organization Name | WESTERN WASHINGTON MEDICAL GROUP, INC PS |
| Other Organization Name | WWMG ARTHRITIS CLINC |
| Practice Address |
1909 214th St Se Suite 211 Bothell WA 98021-4412 |
| Mailing Address |
1728 W Marine View Dr Suite 110 Everett WA 98201-2094 |
| Practice Telephone | 4252482626 |
| Practice Fax Number | 4252482627 |
| Mailing Telephone | 4252482626 |
| Mailing Fax Number | 4252482627 |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-01-30 |
| Authorized Official Name | KIM HOLSTEIN (DIRECTOR PFS) |
| Authorized Official Telephone | 4252482626 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| WWMG Arthritis Clinc | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023236528 | Western Washington Medical Group, Inc Ps | Internal Medicine | 4225 Hoyt Ave Ste A, Everett, WA 98203-2351 | 2007-04-23 |
| 1649498049 | Western Washington Medical Group, Inc Ps | Family Medicine | 4225 Hoyt Ave Ste B, Everett, WA 98203-2351 | 2007-04-23 |
| 1932327335 | Western Washington Medical Group, Inc Ps | Podiatrist | 3202 Colby Ave Ste E, Everett, WA 98201-4324 | 2007-04-23 |
| 1326266727 | Western Washington Medical Group, Inc Ps | Psychologist | 3525 Colby Ave Ste 200, Everett, WA 98201-4782 | 2007-04-23 |
| 1538387931 | Western Washington Medical Group, Inc Ps | Urology | 4310 Colby Ave Ste 203, Everett, WA 98203-2338 | 2007-04-23 |
| 1093933491 | Western Washington Medical Group, Inc Ps | Internal Medicine | 1330 Rockefeller Ave Ste 330, Everett, WA 98201 | 2007-04-23 |
| 1417175811 | Western Washington Medical Group, Inc Ps | Internal Medicine | 1330 Rockefeller Ave Ste 450, Everett, WA 98201-1677 | 2007-04-23 |
| 1831238443 | Western Washington Medical Group, Inc Ps | Spec/Tech, Pathology | 6825 216th St Sw Ste E, Lynnwood, WA 98036-7379 | 2007-02-06 |
| 1003809229 | Western Washington Medical Group, Inc Ps | Clinic/Center | 3501 Shelby Rd, Suite B, Lynnwood, WA 98087-3599 | 2005-08-23 |
| 1568916682 | Western Washington Medical Group, Inc Ps | Psychiatry & Neurology | 12728 19th Ave Se, Suite 300, Everett, WA 98208-6526 | 2016-08-05 |
| Street Address |
1909 214TH ST SE SUITE 211 |
| City | BOTHELL |
| State | WA |
| Zip Code | 98021-4412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659353290 | James David Brown | Internal Medicine | 1909 214th St Se, Suite 110, Bothell, WA 98021-4412 | 2005-11-18 |
| 1740729920 | Gerald Ralph Johnson | Pharmacist | 1909 214th St Se, Suite 300, Bothell, WA 98021-4412 | 2017-02-21 |
| 1831641166 | Kathleen Bradley | Dietitian, Registered | 1909 214th St Se, #300, Bothell, WA 98021-4412 | 2016-11-03 |
| 1588098115 | Daniella Rose Cannone | Physical Therapist | 1909 214th St Se, Suite 300, Bothell, WA 98021-4412 | 2013-08-30 |
| 1043643885 | Lauren B Jentges | Physical Therapist | 1909 214th St Se, Suite 300, Bothell, WA 98021-4412 | 2013-08-15 |
| 1649535642 | Western Washington Medical Group Inc Ps | Dietitian, Registered | 1909 214th St Se, Suite 211, Bothell, WA 98021-4412 | 2012-07-06 |
| 1518225416 | Ada Otter | Nurse Practitioner | 1909 214th St Se, Suite 300, Bothell, WA 98021-4412 | 2012-04-27 |
| 1417226788 | Laboratory Corporation of America | Clinical Medical Laboratory | 1909 214th St Se, Ste 300, Bothell, WA 98021-4412 | 2011-12-15 |
| 1760765598 | Western Washington Medical Group, Inc Ps | Internal Medicine | 1909 214th St Se, Bothell, WA 98021-4412 | 2011-09-28 |
| 1023324217 | Dynacare Northwest Inc | Clinical Medical Laboratory | 1909 214th St Se, Ste 300, Bothell, WA 98021-4412 | 2010-08-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265057780 | Seyed Ali Hosseini | Medical Genetics | 4299 233rd Pl Se, Bothell, WA 98021 | 2020-06-10 |
| 1710440359 | Hiu Nam Wong | Specialist/Technologist | 23419 17th Avenue Southeast, Bothell, WA 98021 | 2019-04-10 |
| 1578029823 | Andrea Lynn Whipple | Speech-Language Pathologist | 1909 124th Street Se, Suite 204, Bothell, WA 98021 | 2019-02-12 |
| 1730656604 | Pavittar Kaur Mansahia | Registered Nurse | Northshore School District, 3330 Monte Villa Parkway, Bothell, WA 98021 | 2018-10-30 |
| 1699261636 | Kellie Joan Wilcox Moore | Naturopath | 2210 242nd St Sw, Bothell, WA 98021 | 2018-07-02 |
| 1174970495 | Tracey Comella | Behavioral Analyst | 2020 Maltby Road Suite 7 Pmb 294, Bothell, WA 98021 | 2016-05-17 |
| 1912332545 | Katherine Marie Zintel | Counselor | 1909 214th St Se Ste 204, Bothell, WA 98021 | 2013-09-13 |
| 1720332471 | Sharon Lynne Deering | Speech-Language Pathologist | 3330 Monte Villa Parkway, Northshore School District, Bothell, WA 98021 | 2012-11-02 |
| 1225302722 | Lynette Patricia Hansen | Massage Therapist | 510 222nd Street Sw, Bothell, WA 98021 | 2012-03-01 |
| 1669749891 | Susie Fox | Dietitian, Registered | 4026 224th St Se#6, Bothell, WA 98021 | 2011-11-16 |
| Find all providers in zip 98021 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467491076 | Jeff Regan Peterson | Internal Medicine | 1909 214th St Se Ste 211, Bothell, WA 98021-4418 | 2006-06-06 |
| 1093918971 | Parul Sharma | Internal Medicine | 1909 214th St Se, Bothell, WA 98021-4412 | 2007-06-07 |
| 1588607808 | Andrew Keith Solomon | Internal Medicine | 1909 214th St Se Ste 211, Bothell, WA 98021-4418 | 2006-06-14 |
| 1366484040 | Richard Alan Houdek Jimenez | Internal Medicine | 1909 214th St Se Ste 211, Bothell, WA 98021-4418 | 2006-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437410354 | Jeonghun Moon | Internal Medicine | 4033 Talbot Rd S Ste 440, Renton, WA 98055-5767 | 2012-06-06 |
| 1356571087 | Christopher C. Wright | Internal Medicine | 105 W 8th Ave Ste 6080, Spokane, WA 99204-2313 | 2009-07-15 |
| 1508094707 | Daniel Jaeung Kim | Internal Medicine | 11311 Bridgeport Way Sw Ste 100, Lakewood, WA 98499-3096 | 2009-06-25 |
| 1962623959 | Wayne J Wallis | Internal Medicine | 2339 Federal Ave E, Seattle, WA 98102-4031 | 2007-05-01 |
| 1639399546 | Robert Lee Johnson | Internal Medicine | 1735 W Sunn Fjord Ln, Apartment I-107, Bremerton, WA 98312-5327 | 2007-04-26 |
| 1093933491 | Western Washington Medical Group, Inc Ps | Internal Medicine | 1330 Rockefeller Ave Ste 330, Everett, WA 98201 | 2007-04-23 |
| 1750433546 | Lisa Vasanth | Internal Medicine | 700 Ne 87th Ave # 330, Vancouver, WA 98664-1913 | 2007-01-18 |
| 1225196215 | John Flint Dickson | Internal Medicine | 714 Bellevue Ave East, #401, Seatlle, WA 98102-5990 | 2006-12-04 |
| 1659445260 | Janice Gupta | Internal Medicine | 515 Minor Avneue, Seattle, WA 98104 | 2006-11-17 |
| 1336218171 | Philip J Mease | Internal Medicine | 1101 Madison St Ste 1000, Seattle, WA 98104-3556 | 2006-11-07 |
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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.