WESTERN WASHINGTON MEDICAL GROUP, INC PS (NPI# 1831238443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831238443 |
| Entity Type | Organization |
| Organization Name | WESTERN WASHINGTON MEDICAL GROUP, INC PS |
| Other Organization Name | WWMG - PATHOLOGY |
| Practice Address |
6825 216th St Sw Ste E Lynnwood WA 98036-7379 |
| Mailing Address |
4225 Hoyt Ave Ste A Everett WA 98203-2351 |
| Practice Telephone | 4252593122 |
| Practice Fax Number | 4252529860 |
| Mailing Telephone | 4252593122 |
| Mailing Fax Number | 4252529860 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2016-02-23 |
| Authorized Official Name | VICKI MCGINNIS (HIPPA PRIVACY OFFICER) |
| Authorized Official Telephone | 4252594041 |
| Is Organization Subpart | Y |
| Parent Organization Name | WESTERN WASHINGTON MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246QH0600X |
Spec/Tech, Pathology Specialization: Histology |
Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | BUSINESS LICENSE | 601474013 | 01 |
| WA | 7137474 | 05 |
| Other Name | Type Code |
|---|---|
| WWMG - Pathology | 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 |
| 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 |
| 1568916682 | Western Washington Medical Group, Inc Ps | Psychiatry & Neurology | 12728 19th Ave Se, Suite 300, Everett, WA 98208-6526 | 2016-08-05 |
| Street Address |
6825 216TH ST SW STE E |
| City | LYNNWOOD |
| State | WA |
| Zip Code | 98036-7379 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342630 | Zachary Perry | Behavior Technician | 4100 Veterans Way, Unit 100, Lynnwood, WA 98036 | 2020-10-08 |
| 1942832795 | Alexis Michelle Solomon-winne | Behavior Technician | 4100 Veterans Way Unit 100 Lynnwood, Wa 98036 United S, Lynnwood, WA 98036 | 2020-02-10 |
| 1881239028 | Endc Pllc | Psychologist | 19217 36th Ave W. Suite 219, Lynnwood, WA 98036 | 2019-11-12 |
| 1225507866 | Kyung Suk Seo | Massage Therapist | 18904 Hwy 99, Ste. K, Lynnwood, WA 98036 | 2018-11-13 |
| 1790270197 | Kabal Sriviboon | Behavior Technician | 20818 44th Ave W Suite 270, Lynnwood, WA 98036 | 2018-06-27 |
| 1992206148 | Kendal Ilyse Borison | Behavioral Analyst | 4100 194th Se, Suite 100, Lynnwood, WA 98036 | 2018-02-23 |
| 1205352515 | Doug Brant | Registered Nurse | 19931 Cypress Way, Lynnwood, WA 98036 | 2017-08-17 |
| 1588184980 | Evergreen Recovery Centers-lynnwood Detox | Substance Abuse Rehabilitation Facility | 20508 56th Ave W, Lynnwood, WA 98036 | 2017-06-27 |
| 1699213439 | Patrick J. Pacyga | Dentist | 19620 Wa-99, Suite 106, Lynnwood, WA 98036 | 2017-02-01 |
| 1134676646 | Fiona Green | Occupational Therapy Assistant | 21503 8th Place W, A, Lynnwood, WA 98036 | 2016-09-01 |
| Find all providers in zip 98036 | ||||
| Taxonomy Code | 246QH0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Spec/Tech, Pathology |
| Specialization | Histology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992962237 | Spokane Digestive Disease Center, P.s. | Spec/Tech, Pathology | 6825 216th St Sw, Suite G, Lynnwood, WA 98036-7379 | 2008-05-22 |
Please comment or provide details below to improve the information on WESTERN WASHINGTON MEDICAL GROUP, INC PS.
| 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.