PUBLIC HOSPITAL DISTRICT NO 2 (NPI# 1568563732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568563732 |
| Entity Type | Organization |
| Organization Name | PUBLIC HOSPITAL DISTRICT NO 2 |
| Other Organization Name | EVERGREEN MEDICAL GROUP DUVALL |
| Practice Address |
14720 Main St Ne Ste 109 Duvall WA 98019-8460 |
| Mailing Address |
Po Box 34036 Seattle WA 98124-1036 |
| Practice Telephone | 4257884889 |
| Practice Fax Number | 4258446116 |
| Mailing Telephone | 4258993292 |
| Mailing Fax Number | 4258993269 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2011-01-04 |
| Authorized Official Name | ROBERT MALTE (CEO) |
| Authorized Official Telephone | 4258992610 |
| Is Organization Subpart | Y |
| Parent Organization Name | PUBLIC HOSPITAL DISTRICT NO 2 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | MEDICARE RAILROAD | CG2833 | 01 |
| WA | MEDICARE RAILROAD | CJ9678 | 01 |
| WA | 7110562 | 05 | |
| WA | MEDICARE RAILROAD | CQ2437 | 01 |
| WA | MEDICARE RAILROAD | CG8137 | 01 |
| Other Name | Type Code |
|---|---|
| Evergreen Medical Group Duvall | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891958153 | Public Hospital District No 2 | Hospice Care, Community Based | 12040 Ne 128th St # Ms -119, Kirkland, WA 98034-3013 | 2008-07-08 |
| 1922198191 | Public Hospital District No 2 | Family Medicine | 17000 140th Ave Ne, Ste 101, Woodinville, WA 98072-6928 | 2006-10-16 |
| 1578653747 | Public Hospital District No 2 | Family Medicine | 8301 161st Ave Ne, Ste 308, Redmond, WA 98052-3858 | 2006-10-16 |
| 1518057793 | Public Hospital District No 2 | Nurse Practitioner | 12303 Ne 130th Ln, # 225, Kirkland, WA 98034-3099 | 2006-10-16 |
| 1629179890 | Public Hospital District No 2 | Family Medicine | 18208 66th Ave Ne, Ste 200, Kenmore, WA 98028-7949 | 2006-09-26 |
| 1942301122 | Public Hospital District No 2 | Family Medicine | 17000 140th Ave Ne, Ste 101, Woodinville, WA 98072-6928 | 2006-09-26 |
| 1417058694 | Public Hospital District No 2 | Family Medicine | 22850 Ne 8th St, Ste 103, Sammamish, WA 98074-7256 | 2006-09-26 |
| 1538260716 | Public Hospital District No 2 | Family Medicine | 8299 161st Ave Ne, Ste 101, Redmond, WA 98052-3860 | 2006-09-26 |
| 1013014786 | Public Hospital District No 2 | Family Medicine | 8301 161st Ave Ne, Suite 105, Redmond, WA 98052-3858 | 2006-09-17 |
| Street Address |
14720 MAIN ST NE STE 109 |
| City | DUVALL |
| State | WA |
| Zip Code | 98019-8460 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821070285 | Sherman Lee | Family Medicine | 14720 Main St Ne, Suite 109, Duvall, WA 98019-8460 | 2005-11-18 |
| 1962503235 | Kristi S. Moffat | Family Medicine | 14720 Main St Ne, Suite 109, Duvall, WA 98019-8460 | 2006-09-26 |
| 1851497549 | Kyle Thomas Krekow | Physician Assistant | 14720 Main St Ne, Suite 109, Duvall, WA 98019-8460 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598240202 | Emily Ellen Squiers | Counselor | 26420 Virginia St, Suite 2, Duvall, WA 98019 | 2018-09-27 |
| 1235629072 | Aubrey Christine Lane | Marriage & Family Therapist | Larch Counseling 15315 1st Avenue Northeast, #205-a, Duvall, WA 98019 | 2018-05-17 |
| 1528505575 | Jackie Schaedler Boak | Registered Nurse | 15309 2nd Ave Ne, Duvall, WA 98019 | 2017-01-30 |
| 1912326778 | Dan Claussen | Marriage & Family Therapist | 15315 Ne 1st Ave Ne, Suite 205-a, Duvall, WA 98019 | 2014-04-09 |
| 1134405509 | Amy R Bush | Physical Therapist | 15435 Main St. Ne #101, Duvall, WA 98019 | 2011-10-28 |
| 1407134919 | Cynthia Rebecca Tyler | Dentist | 26504 Ne Valley Street, Duvall, WA 98019 | 2011-08-01 |
| 1215256730 | Diane Zakrajsek | Dietitian, Registered | 26502 Ne Valley Street Suite 102, Duvall, WA 98019 | 2010-05-24 |
| 1093917320 | Jolynn Wagner | Psychologist | 26502 Ne Valley St Suite 101, Duvall, WA 98019 | 2007-05-31 |
| 1760690242 | Rebecca Jean Maxcy | Specialist | 15705 Main St, Duvall, WA 98019 | 2007-05-18 |
| 1538377064 | The Camelot Society | Intermediate Care Facility, Mentally Retarded | 26509 N.e. Virginia St., Duvall, WA 98019 | 2007-05-18 |
| Find all providers in zip 98019 | ||||
| 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 |
|---|---|---|---|---|
| 1316178726 | Dannelle J Carlson | Family Medicine | 29414 Ne Big Rock Rd, Duvall, WA 98019-7337 | 2009-08-03 |
| 1821070285 | Sherman Lee | Family Medicine | 14720 Main St Ne, Suite 109, Duvall, WA 98019-8460 | 2005-11-18 |
| 1376525741 | Phillip Edward Milam | Family Medicine | 15602 Main St. Ne, 200, Duvall, WA 98019 | 2005-11-18 |
| 1962503235 | Kristi S. Moffat | Family Medicine | 14720 Main St Ne, Suite 109, Duvall, WA 98019-8460 | 2006-09-26 |
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| 1063010957 | Olympic Medical Pllc | Family Medicine | 6342 Littlerock Rd Sw Bldg 3, Tumwater, WA 98512-7332 | 2020-10-13 |
| 1124631296 | Direct Care Clinics Us PC | Family Medicine | 2307 Se 3rd Circle, Suite 203, Vancouver, WA 98661-9860 | 2020-08-28 |
| 1851902605 | Northwest Clinical Services | Family Medicine | 825 Se Bishop Blvd Ste 301c, Pullman, WA 99163-5517 | 2020-08-14 |
| 1003424128 | Kelly P Grenner | Family Medicine | 15424 Ne 160th St, Woodinville, WA 98072-8180 | 2020-07-14 |
| 1851919476 | Thuthi Enterprises, LLC | Family Medicine | 715 N Park Ctr # A, Selah, WA 98942-1174 | 2020-07-09 |
| 1851917074 | Kaiser Foundation Health Plan of Washington | Family Medicine | 5216 Point Fosdick Dr # 102, Gig Harbor, WA 98335-0037 | 2020-06-23 |
| 1245856830 | Jackie C Toh | Family Medicine | 13684 18th Ave Sw, Burien, WA 98166-1047 | 2020-06-19 |
| 1669097127 | Dawnmd LLC | Family Medicine | 540 E Main St Ste A, Pullman, WA 99163-2660 | 2020-06-10 |
| 1427672310 | Andrea Lauren Cistulli | Family Medicine | 3619 Talbot Rd S Ste 401, Renton, WA 98055-5708 | 2020-06-05 |
| 1114540457 | Country Doctor Community Clinic | Family Medicine | 2410 E Cherry St, Seattle, WA 98122-4832 | 2020-05-21 |
| Find all providers with the same taxonomy | ||||
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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.