BARIATRIC SURGERY CLINIC TRUST (NPI# 1679754139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679754139 |
| Entity Type | Organization |
| Organization Name | BARIATRIC SURGERY CLINIC TRUST |
| Other Organization Name | SEATTLE PACIFIC SURGEONS/NICOLE WHITE/BENJAMIN LERNER/TERENCE QUIGLEY |
| Practice Address |
1560 N 115th St Suite 102 Seattle WA 98133-8414 |
| Practice Telephone | 2063681070 |
| Practice Fax Number | 2063634172 |
| Mailing Telephone | 2063681070 |
| Mailing Fax Number | 2063634172 |
| Enumeration Date | 2007-11-26 |
| Last Update Date | 2010-11-11 |
| Authorized Official Name | MR. CHARLES W SCHNEIDER (CEO) |
| Authorized Official Telephone | 2063681700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDIC AL LICENSE | MD00043626 | 01 |
| Other Name | Type Code |
|---|---|
| SEATTLE PACIFIC SURGEONS/NICOLE WHITE/BENJAMIN LERNER/TERENCE QUIGLEY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457793390 | Bariatric Surgery Clinic Trust | Surgery | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2013-07-19 |
| Street Address |
1560 N 115TH ST SUITE 102 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98133-8414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275539546 | Helena B Jones | Internal Medicine | 1560 N 115th St, Ste G-10, Seattle, WA 98133-8414 | 2005-06-22 |
| 1386084903 | Derman Pllc | General Acute Care Hospital | 1560 N 115th St, Suite 201, Seattle, WA 98133-8414 | 2013-06-27 |
| 1164782975 | Northwest Obstetrics & Gynecology | Obstetrics & Gynecology | 1560 N 115th St, Suite 109, Seattle, WA 98133-8414 | 2012-05-25 |
| 1104185644 | Johnathon Curtis Rollo | Surgery | 1560 N 115th St, Seattle, WA 98133-8414 | 2012-05-03 |
| 1861780264 | Teresa Lynn Gegax-martinez | Nurse Practitioner | 1560 N 115th St, Ms W-201, Seattle, WA 98133-8414 | 2011-07-19 |
| 1184917569 | Pacific Medical, Inc. | Durable Medical Equipment & Medical Supplies | 1560 N 115th St, Suite G-10, Seattle, WA 98133-8414 | 2011-05-18 |
| 1295056323 | Paul Samuel Martin | Internal Medicine | 1560 N 115th St, Seattle, WA 98133-8414 | 2010-06-11 |
| 1518297308 | Wound Care Center Tr | Nurse Practitioner | 1560 N 115th St, Suite 201, Seattle, WA 98133-8414 | 2009-12-30 |
| 1063740058 | Deep Brain Stimulation Tr | Nurse Practitioner | 1560 N 115th St, Suite G-5, Seattle, WA 98133-8414 | 2009-12-02 |
| 1700016391 | Nilufer B Norsworthy | Internal Medicine | 1560 N 115th St, Suite 201, Seattle, WA 98133-8414 | 2009-07-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339388 | Marni Lynn Hanig | Occupational Therapist | 1900 N 170th St., Shoreline, WA 98133 | 2019-10-29 |
| 1871074807 | Minju Kim | Counselor | 14332 Burke Ave N, Seattle, WA 98133 | 2018-08-27 |
| 1821582941 | Hana Alema Misgina | Registered Nurse | 927 N 199th St, Shoreline, WA 98133 | 2018-06-21 |
| 1588177729 | Julie Benefiel | Pharmacist | 1536 N 115th St. Suite 100, Seattle, WA 98133 | 2017-11-09 |
| 1730607953 | Aurora Oaks, LLC | Skilled Nursing Facility | 16357 Aurora Avenue North, Shoreline, WA 98133 | 2017-09-08 |
| 1750801072 | Zoe Ana Cavnar-lewandowski | Counselor | 10700 Meridian Avenue N, Suite G-11, Seattle, WA 98133 | 2017-06-27 |
| 1851820211 | Adam Lee Gardner Sr. | Acupuncturist | 925 N 163rd Street, Unit B, Shoreline, WA 98133 | 2017-06-08 |
| 1376085209 | Pamela Ashby | Counselor | 2111 N. Northgateway, 212, Seattle, WA 98133 | 2016-11-09 |
| 1225584956 | General Dentistry | Dentist | 20109 Aurora Ave N, Ste D, Shoreline, WA 98133 | 2016-09-01 |
| 1144672668 | Aaron Neubauer | Behavioral Analyst | 13407 Greenwood Ave N, 216c, Seattle, WA 98133 | 2016-07-08 |
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| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477181758 | Michael Joseph Skerda | Surgery | 747 Broadway Apt 111, Seattle, WA 98122-4307 | 2020-03-31 |
| 1184185779 | Arezu Hajar Monawer | Surgery | 747 Broadway Bldg 10th, Seattle, WA 98122-4307 | 2019-03-27 |
| 1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
| 1891248969 | Jad Abou-khalil | Surgery | 1430 Summit Ave, Appt 502, Seattle, WA 98122-3533 | 2016-07-25 |
| 1285016196 | Amer Nassar | Surgery | Department of Surgery Education, University of Washington, Box 356410, Seattle, WA 98195-0001 | 2015-06-27 |
| 1477949857 | Richard Stein | Surgery | 4545 8th Ave Ne, Apt 610, Seattle, WA 98105-5795 | 2015-04-12 |
| 1518353044 | Brian Cook | Surgery | 815 Mercer St. Box 358047, Uw Medicine South Lake Union, Seattle, WA 98109-4325 | 2015-04-10 |
| 1073956058 | Colette S. Inaba | Surgery | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2013-04-09 |
| 1518223122 | Joy Candace Chen | Surgery | 1959 Ne Pacific St Bb-487 Box #356410, Seattle, WA 98195-2462 | 2012-04-09 |
| 1851680102 | Lara Senekjian | Surgery | Po Box 359796, Seattle, WA 98195-9796 | 2011-04-06 |
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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.