WESTERN WASHINGTON MEDICAL GROUP, INC PS (NPI# 1760765598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760765598 |
| Entity Type | Organization |
| Organization Name | WESTERN WASHINGTON MEDICAL GROUP, INC PS |
| Other Organization Name | WESTERN WASHINGTON MEDICAL GROUP DEPT OF INTERNAL MEDICINE |
| Practice Address |
1909 214th St Se Bothell WA 98021-4412 |
| Mailing Address |
1728 W Marine View Dr Suite 110 Everett WA 98201-2094 |
| Practice Telephone | 4254201655 |
| Practice Fax Number | 4254201651 |
| Mailing Telephone | 4252594041 |
| Mailing Fax Number | 4257404123 |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2016-10-13 |
| Authorized Official Name | KIMBERLY HOLSTEIN (DIRECTOR OF PATIENT FINANCIAL SERVI) |
| Authorized Official Telephone | 4252594041 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Western Washington Medical Group Dept of Internal Medicine | 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 |
| 1538606413 | Western Washington Medical Group, Inc Ps | Internal Medicine | 1909 214th St Se, Suite 211, Bothell, WA 98021-4412 | 2017-01-30 |
| Street Address |
1909 214TH ST SE |
| 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 |
| 1538606413 | Western Washington Medical Group, Inc Ps | Internal Medicine | 1909 214th St Se, Suite 211, Bothell, WA 98021-4412 | 2017-01-30 |
| 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 |
| 1023324217 | Dynacare Northwest Inc | Clinical Medical Laboratory | 1909 214th St Se, Ste 300, Bothell, WA 98021-4412 | 2010-08-25 |
| Find all providers in the same location | ||||
| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1104182757 | Shiquan Liu | Internal Medicine | 10701 E Riverside Dr, Apt# 2, Bothell, WA 98011 | 2012-04-09 |
| 1861591786 | Jeong H. Kim | Internal Medicine | 11812 N Creek Pkwy N Ste 202, Bothell, WA 98011 | 2006-09-21 |
| 1922052422 | Lakeshore Clinic Pllc | Internal Medicine | 10131 Main St, Bothell, WA 98011-3425 | 2006-05-19 |
| 1659353290 | James David Brown | Internal Medicine | 1909 214th St Se, Suite 110, Bothell, WA 98021-4412 | 2005-11-18 |
| 1073502829 | Ruth A. Freeman | Internal Medicine | 1908 201st Pl Se Ste 100, Bothell, WA 98012-8572 | 2005-10-14 |
| 1801394341 | Dr. Ruth Freeman | Internal Medicine | 1908 201st Pl Se Ste 100, Bothell, WA 98012 | 2018-01-30 |
| 1588103451 | Pacmed Clinics | Internal Medicine | 1909 214th St Se Ste 300, Bothell, WA 98021 | 2017-02-13 |
| 1659814762 | King County Public Hospital District No 2 | Internal Medicine | 10131 Main St, Bothell, WA 98011-3425 | 2016-11-21 |
| 1013450386 | King County Public Hospital District No 2 | Internal Medicine | 10131 Main St, Bothell, WA 98011-3425 | 2016-11-18 |
| 1689022717 | Adewunmi Nuga | Internal Medicine | 1909 214th St Se Ste 300, Bothell, WA 98021-4418 | 2016-05-31 |
| Find all providers in BOTHELL | ||||
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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.