MOLINA HEALTHCARE OF WASHINGTON, INC (NPI# 1891000725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891000725 |
| Entity Type | Organization |
| Organization Name | MOLINA HEALTHCARE OF WASHINGTON, INC |
| Other Organization Name | MOLINA MEDICAL GROUP - WASHINGTON |
| Practice Address |
15 Sw Everett Mall Way Suite A Everett WA 98208-2777 |
| Mailing Address |
200 Oceangate Suite 100 Long Beach CA 90802-4317 |
| Practice Telephone | 5624996191 |
| Practice Fax Number | 5624996171 |
| Mailing Telephone | 5624996191 |
| Mailing Fax Number | 5624996171 |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2011-09-27 |
| Authorized Official Name | GLORIA CALDERON (VP, CLINIC OPERATIONS) |
| Authorized Official Telephone | 5624996191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2010594 | 05 |
| Other Name | Type Code |
|---|---|
| Molina Medical Group - Washington | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912235060 | Molina Healthcare of Washington, Inc | Pediatrics | 3322 Broadway, Suite 200, Everett, WA 98201-4425 | 2009-12-01 |
| 1659897163 | Molina Healthcare of Washington, Inc | Internal Medicine | 15 Sw Everett Mall Way Ste A, Everett, WA 98204-2715 | 2017-08-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MOLINA HEALTHCARE OF WASHINGTON, INC. | 21540 30th Drive Se, Suite 400, Bothell, WA 98021 |
| Colorado Business Entities | Molina Healthcare of Washington, Inc. | 21540 30th Drive Se, Suite 400, Bothell, WA 98021 |
| Street Address |
15 SW EVERETT MALL WAY SUITE A |
| City | EVERETT |
| State | WA |
| Zip Code | 98208-2777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710946108 | Ayad Joseph Dawood | Internal Medicine | 15 Sw Everett Mall Way, Suite A, Everett, WA 98204-2715 | 2006-03-22 |
| 1457785750 | Allison Kate Berglin | Nurse Practitioner | 15 Sw Everett Mall Way, Suite A, Everett, WA 98204-2715 | 2013-08-22 |
| 1891042180 | Christopher Soterakopoulos | Physical Therapist | 15 Sw Everett Mall Way, Ste G, Everett, WA 98204-2715 | 2012-08-06 |
| 1073873808 | Ryan Everett Culp | Chiropractor | 15 Sw Everett Mall Way, Ste G, Everett, WA 98204-2715 | 2012-05-27 |
| 1700158417 | Joseph M Molina Md Professional Corporation-southern California | Internal Medicine | 15 Sw Everett Mall Way, Suite A, Everett, WA 98204-2715 | 2012-01-27 |
| 1467739326 | Jimmy Greer | Chiropractor | 15 Sw Everett Mall Way, Ste G, Everett, WA 98204-2715 | 2011-11-07 |
| 1235415670 | Diana Lam | Chiropractor | 15 Sw Everett Mall Way, Ste G, Everett, WA 98204-2715 | 2011-10-31 |
| 1871642082 | Thomas Eugene Horst | Family Medicine | 15 Sw Everett Mall Way, Suite A, Everett, WA 98204-2715 | 2007-01-09 |
| 1841357621 | Magdalena M Walczak | Family Medicine | 15 Sw Everett Mall Way, Suite A, Everett, WA 98204-2715 | 2007-01-02 |
| 1356394258 | Marcia M Wharton | Family Medicine | 15 Sw Everett Mall Way, Everett, WA 98204-2715 | 2006-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790270296 | Kenneth Britt Dyer | Registered Nurse | 10333 19th Ave, Se, Ste #109, Everett, WA 98208 | 2018-06-27 |
| 1518482215 | Glacier Peak Healthcare, Inc. | Home Health | 10530 19th Ave Se Ste 201, Everett, WA 98208 | 2017-08-03 |
| 1114454865 | Aliza Kreisman | Registered Nurse | 11020 19th Avenue Se, Kaiser Permanente of Washington Seattle Care Clinic, Everett, WA 98208 | 2017-05-12 |
| 1902269418 | Clay Eakin | Counselor | 2732 Grand Evenue, Everett, WA 98208 | 2016-04-01 |
| 1467810259 | Elizabeth Anne Powley | Marriage & Family Therapist | 1920 100th Street Southeast, Bld C3, Everett, WA 98208 | 2016-02-08 |
| 1659745842 | Andrea Rose Bedlington | Pharmacist | 11407 33rd Dr. Se, Everett, WA 98208 | 2015-11-25 |
| 1396123865 | Sound Surgeons Pllc | Clinic/Center | 125 130th Street Se, 1st Floor, Everett, WA 98208 | 2015-05-15 |
| 1831576537 | Chris Sturgeon | Counselor | 10102 Meridian Ave, Everett, WA 98208 | 2015-05-01 |
| 1982011128 | James M Lee | Physical Therapist | 10821 19th Ave Se Ste 102, Everett, WA 98208 | 2014-07-21 |
| 1972937357 | Ronald Tracy | Dentist | 10315 19th Avenue Se Suite 110, Everett, WA 98208 | 2013-08-21 |
| Find all providers in zip 98208 | ||||
| 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 |
|---|---|---|---|---|
| 1649882275 | Blair Regenerative Medicine LLC | Family Medicine | 201 Hospital Dr Ste 2, Everett, PA 15537-7019 | 2020-08-17 |
| 1366856569 | Bowhee Sohn Gwak | Family Medicine | 12800 Bothell Everett Hwy Ste 160, Everett, WA 98208-6644 | 2014-06-16 |
| 1518392513 | Bernadette Flynn | Family Medicine | 41 W 1st St, Everett, PA 15537-1103 | 2013-09-09 |
| 1801164058 | Charles William Starbuck | Family Medicine | 3605 Shore Avenue, Everett, WA 98203-1209 | 2011-12-02 |
| 1649498049 | Western Washington Medical Group, Inc Ps | Family Medicine | 4225 Hoyt Ave Ste B, Everett, WA 98203-2351 | 2007-04-23 |
| 1689790792 | Del Whetstone | Family Medicine | 9629 Evergreen Way, Suite 102, Everett, WA 98204-7198 | 2007-03-21 |
| 1497843213 | Vincent M. Koike | Family Medicine | 7601 Evergreen Way, B-6, Everett, WA 98203 | 2006-10-10 |
| 1295820942 | North Creek Medicine Inc P S | Family Medicine | 210 128th St Se, Everett, WA 98208-6338 | 2006-10-04 |
| 1376644518 | Thomas G. Pautler | Family Medicine | 5007 Claremont Way, Everett, WA 98203-3321 | 2006-09-26 |
| 1487662581 | Allison M Cole | Family Medicine | 1410 Broadway, Everett, WA 98201-1720 | 2006-08-04 |
| Find all providers in EVERETT | ||||
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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.