ISSAQUAH MEDICAL GROUP (NPI# 1912043720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912043720 |
| Entity Type | Organization |
| Organization Name | ISSAQUAH MEDICAL GROUP |
| Practice Address |
450 Nw Gilman Blvd Ste 201 Issaquah WA 98027-2483 |
| Practice Telephone | 4253910705 |
| Practice Fax Number | 4253919562 |
| Mailing Telephone | 4253910705 |
| Mailing Fax Number | 4253919562 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHAEL P HOURIGAN (ADMINISTRATOR) |
| Authorized Official Telephone | 4252919562 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OP00000637 | WA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649316266 | Issaquah Medical Group | Pediatrics | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2483 | 2007-01-30 |
| Street Address |
450 NW GILMAN BLVD STE 201 |
| City | ISSAQUAH |
| State | WA |
| Zip Code | 98027-2483 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145205 | Ashley Maria Gundermann | Naturopath | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2722 | 2020-05-12 |
| 1992339295 | Della Harrison | Acupuncturist | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2722 | 2020-02-25 |
| 1295386589 | Jaime Cloyd | Naturopath | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2722 | 2019-09-27 |
| 1700341955 | Chris James Sokolick Jr. | Chiropractor | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2722 | 2019-02-01 |
| 1366913048 | Jessica Stark | Psychologist | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2722 | 2018-12-06 |
| 1366922957 | Lorraine Rasmussen | Massage Therapist | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2722 | 2018-08-14 |
| 1205313194 | Elizabeth Anne Wing | Naturopath | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2722 | 2018-07-23 |
| 1972027340 | Anna Flies | Acupuncturist | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027 | 2017-07-27 |
| 1437681756 | Tiffany Leeann Althaus | Naturopath | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2722 | 2017-03-28 |
| 1992240790 | Natalie Willits | Acupuncturist | 450 Nw Gilman Blvd Ste 201, Issaquah, WA 98027-2722 | 2017-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780281840 | Cascade Hand & Orthopedic Rehab, Inc. | Clinic/Center | 1301 4th Avenue Nw, Suite 200, Issaquah, WA 98027 | 2020-10-01 |
| 1700494630 | Genevieve S Ward | Counselor | 22500 Se 64th Place, Building G, Suite 150, Issaquah, WA 98027 | 2020-07-16 |
| 1891338604 | Amy Mezulis | Psychologist | 1740 Nw Maple St. #210, Issaquah, WA 98027 | 2019-10-24 |
| 1578055083 | Vivian Yu-en Hsiao | Physical Therapist | 1301 4th Ave Nw Ste 300, Issaquah, WA 98027 | 2018-05-31 |
| 1831698000 | Peter James Carlson | Physical Therapist | 22500 Se 64th Place, Building G, Suite 115, Issaquah, WA 98027 | 2018-02-02 |
| 1902323553 | David Robert Primrose | Dentist | 600 Nw Gilman Blvd Ste B, Issaquah, WA 98027 | 2017-08-24 |
| 1083135446 | Tara Rose | Massage Therapist | 680 Nw Gilman Blvd., Ste. A, Issaquah, WA 98027 | 2017-07-06 |
| 1295276194 | Amy Davenport | Occupational Therapist | 1871 Nw Gilman Blvd #2, Issaquah, WA 98027 | 2017-03-13 |
| 1942751771 | Krista L Gibbons | Counselor | 1700 Nw Blvd, Suite #200, Issaquah, WA 98027 | 2016-10-17 |
| 1376903237 | Kari Wathen Torres | Occupational Therapist | 710 Nw Juniper St Ste 100, Issaquah, WA 98027 | 2016-03-03 |
| Find all providers in zip 98027 | ||||
| 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 |
|---|---|---|---|---|
| 1194110908 | May Y. Mar | Family Medicine | 5708 E. Lake Sammamish Pkwy Se, Issaquah, WA 98029 | 2015-03-30 |
| 1083909428 | Michelle Angelika Kauffman | Family Medicine | 5708 E Lake Sammamish Pkwy Se Ste 102, Issaquah, WA 98029-8942 | 2011-06-14 |
| 1073772539 | Lee Ha Chan | Family Medicine | 3710 Providence Point Dr Se, Issaquah, WA 98029-6242 | 2008-06-09 |
| 1225295330 | Elizabeth Mullen Bennett | Family Medicine | 415 Everwood Ct Nw, Issaquah, WA 98027-2602 | 2008-05-19 |
| 1083751333 | Sarah Hiam | Family Medicine | 5708 E. Lake Sammamish Pkwy, Issaquah, WA 98129 | 2007-01-30 |
| 1699840769 | Rebecca Jean Richardson | Family Medicine | 18501 Se Newport Way, #f-129, Issaquah, WA 98027-9036 | 2006-11-22 |
| 1063590529 | Anthony Scott Barnett | Family Medicine | 751 Ne Blakely Dr., Suite 5010, Issaquah, WA 98029-6201 | 2006-11-01 |
| 1821173279 | David S Farrell | Family Medicine | 3707 Providence Point Dr Se, Ste G, Issaquah, WA 98029-6216 | 2006-10-26 |
| 1760490692 | Reinier Dejong Vancoevorden | Family Medicine | 1490 Nw Gilman Blvd., Issaquah, WA 98027 | 2006-08-04 |
| 1396768412 | Samantha Marie Maplethorpe | Family Medicine | 3707 Providence Point Dr Se Ste G, Issaquah, WA 98029-6216 | 2006-07-26 |
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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.