RENOVO MEDICAL GROUP (NPI# 1801214481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801214481 |
| Entity Type | Organization |
| Organization Name | RENOVO MEDICAL GROUP |
| Practice Address |
19930 Ballinger Way Ne Shoreline WA 98155-1223 |
| Practice Telephone | 4257782220 |
| Mailing Telephone | 4257782220 |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2018-01-04 |
| Authorized Official Name | CHERYL HAMILL (OPERATIONS MANAGER) |
| Authorized Official Telephone | 4257782220 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275931982 | Renovo Medical Group | Family Medicine | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2014-12-11 |
| 1649680547 | Renovo Medical Group | Internal Medicine | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2014-04-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | RENOVO MEDICAL GROUP, PLLC | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 |
| Street Address |
19930 BALLINGER WAY NE |
| City | SHORELINE |
| State | WA |
| Zip Code | 98155-1223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467493890 | Northwest Hand Specialists, Inc., P.s. | Orthopaedic Surgery | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2006-06-09 |
| 1366003899 | Breanne Haberman | Nurse Practitioner | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2019-06-25 |
| 1942791652 | Nora Delavari | Dietitian, Registered | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2018-05-29 |
| 1578097705 | Kimberly Haban Morris | Dietitian, Registered | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2017-04-14 |
| 1801241690 | Bradley Butterfield | Counselor | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2016-04-28 |
| 1922477645 | Puget Sound Surgical Center | Clinic/Center | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2015-09-23 |
| 1922486356 | Puget Sound Surgical Center | Marriage & Family Therapist | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2015-05-18 |
| 1275931982 | Renovo Medical Group | Family Medicine | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2014-12-11 |
| 1043612690 | Julia Engel | Dietitian, Registered | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2014-09-25 |
| 1407267479 | Timothy Dennis Maland | Registered Nurse | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2014-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922575703 | Dale Worrell | Counselor | Center for Human Services, 17018 15th Ave Ne, Shoreline, WA 98155 | 2018-10-30 |
| 1770060568 | Jason Freed | Occupational Therapist | 1250 Ne 145th St., Shoreline, WA 98155 | 2018-07-24 |
| 1497208771 | Mirit Markowitz | Counselor | 14803 15 Ave Ne, Seattle, WA 98155 | 2016-08-03 |
| 1003207788 | Jessica Hinckley | Counselor | 17018 15tth Ave Ne, Shoreline, WA 98155 | 2015-02-17 |
| 1407119001 | Erika Tydor | Optometrist | 18021 15th Ave Ne Suite 100, Shoreline, WA 98155 | 2012-06-19 |
| 1891075917 | Kieran Joseph Mcmanimon | Massage Therapist | 18724 35th Ave Ne, Lake Forest Park, WA 98155 | 2011-08-20 |
| 1376841270 | Kym Kolb | Massage Therapist | 17908 15th Ave Ne, Shoreline, WA 98155 | 2011-03-02 |
| 1205069333 | Acclaim Body Care, LLC | Massage Therapist | 17517 15th Ave., Suite B, Shoreline, WA 98155 | 2009-08-24 |
| 1881834570 | Jason Sailesh Dave | Naturopath | 2871 University St, Seattle, WA 98155 | 2009-02-20 |
| 1396918975 | Ashleigh Veronique Schultz | Counselor | 216 Ne 175th Street, Shoreline, WA 98155 | 2008-04-04 |
| Find all providers in zip 98155 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295168060 | Sound Infectious Disease, Pllc | Specialist | 405 N 179th Pl, Shoreline, WA 98133-4710 | 2013-08-15 |
| 1992096523 | Cortney Leigh Brown | Specialist | 18820 Aurora Ave N Ste 102, Shoreline, WA 98133-3900 | 2011-04-30 |
| 1558531392 | Erin Marie Cleary | Specialist | 19919 Wallingford Ave N, Shoreline, WA 98133-3728 | 2008-03-07 |
| 1356538755 | John L Tullis IIi | Specialist | 19708 15th Ave Ne, Suite A, Shoreline, WA 98155-1189 | 2007-09-28 |
| 1063623528 | Reggi Shelley | Specialist | 19909 Ballinger Way Ne, Suite 100, Shoreline, WA 98155-1222 | 2007-05-25 |
| 1932316650 | Eva B Salamonik | Specialist | 15617 1st Ave Nw, Shoreline, WA 98177-3623 | 2007-05-16 |
| 1699981084 | Pamela Jo Champagne-l'esperance | Specialist | 1331 N 180th St, Shoreline, WA 98133-4502 | 2007-05-15 |
| 1386778124 | Hang Sig Kim | Specialist | 1207 N 200th St Ste 105, Shoreline, WA 98133-3213 | 2007-03-15 |
| 1205979200 | Becky Louise Kirschner-henriot | Specialist | 1207 N 200th St Ste 101, Shoreline, WA 98133-3213 | 2007-02-15 |
| 1578606216 | Belinda Daisy Thompson | Specialist | 20202 Ballinger Way Ne, Shoreline, WA 98155-1144 | 2007-02-14 |
| Find all providers in SHORELINE | ||||
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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.