JOHNATHON CURTIS ROLLO (NPI# 1104185644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104185644 |
| Entity Type | Individual |
| Full Name | JOHNATHON CURTIS ROLLO |
| Credential | MD |
| Practice Address |
1560 N 115th St Seattle WA 98133-8414 |
| Mailing Address |
Po Box 50095 Seattle WA 98145-5095 |
| Practice Telephone | 2066685864 |
| Mailing Telephone | (206) 543-6420 |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2017-08-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD60748391 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1104185644 | 05 | |
| WA | MEDICARE PIN | 8967381 | 01 |
| Street Address |
1560 N 115TH ST |
| City | SEATTLE |
| State | WA |
| Zip Code | 98133-8414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275539546 | Helena B Jones | Internal Medicine | 1560 N 115th St, Ste G-10, Seattle, WA 98133-8414 | 2005-06-22 |
| 1386084903 | Derman Pllc | General Acute Care Hospital | 1560 N 115th St, Suite 201, Seattle, WA 98133-8414 | 2013-06-27 |
| 1164782975 | Northwest Obstetrics & Gynecology | Obstetrics & Gynecology | 1560 N 115th St, Suite 109, Seattle, WA 98133-8414 | 2012-05-25 |
| 1861780264 | Teresa Lynn Gegax-martinez | Nurse Practitioner | 1560 N 115th St, Ms W-201, Seattle, WA 98133-8414 | 2011-07-19 |
| 1184917569 | Pacific Medical, Inc. | Durable Medical Equipment & Medical Supplies | 1560 N 115th St, Suite G-10, Seattle, WA 98133-8414 | 2011-05-18 |
| 1295056323 | Paul Samuel Martin | Internal Medicine | 1560 N 115th St, Seattle, WA 98133-8414 | 2010-06-11 |
| 1518297308 | Wound Care Center Tr | Nurse Practitioner | 1560 N 115th St, Suite 201, Seattle, WA 98133-8414 | 2009-12-30 |
| 1063740058 | Deep Brain Stimulation Tr | Nurse Practitioner | 1560 N 115th St, Suite G-5, Seattle, WA 98133-8414 | 2009-12-02 |
| 1700016391 | Nilufer B Norsworthy | Internal Medicine | 1560 N 115th St, Suite 201, Seattle, WA 98133-8414 | 2009-07-17 |
| 1720218514 | Bijan Justin Ghassemieh | Internal Medicine | 1560 N 115th St, Suite G10, Seattle, WA 98133-8414 | 2009-07-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339388 | Marni Lynn Hanig | Occupational Therapist | 1900 N 170th St., Shoreline, WA 98133 | 2019-10-29 |
| 1871074807 | Minju Kim | Counselor | 14332 Burke Ave N, Seattle, WA 98133 | 2018-08-27 |
| 1821582941 | Hana Alema Misgina | Registered Nurse | 927 N 199th St, Shoreline, WA 98133 | 2018-06-21 |
| 1588177729 | Julie Benefiel | Pharmacist | 1536 N 115th St. Suite 100, Seattle, WA 98133 | 2017-11-09 |
| 1730607953 | Aurora Oaks, LLC | Skilled Nursing Facility | 16357 Aurora Avenue North, Shoreline, WA 98133 | 2017-09-08 |
| 1750801072 | Zoe Ana Cavnar-lewandowski | Counselor | 10700 Meridian Avenue N, Suite G-11, Seattle, WA 98133 | 2017-06-27 |
| 1851820211 | Adam Lee Gardner Sr. | Acupuncturist | 925 N 163rd Street, Unit B, Shoreline, WA 98133 | 2017-06-08 |
| 1376085209 | Pamela Ashby | Counselor | 2111 N. Northgateway, 212, Seattle, WA 98133 | 2016-11-09 |
| 1225584956 | General Dentistry | Dentist | 20109 Aurora Ave N, Ste D, Shoreline, WA 98133 | 2016-09-01 |
| 1144672668 | Aaron Neubauer | Behavioral Analyst | 13407 Greenwood Ave N, 216c, Seattle, WA 98133 | 2016-07-08 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
| 1891986097 | Vascular Associates, Ps | Surgery | 801 Broadway Ste 522, Seattle, WA 98122-4325 | 2007-08-05 |
| 1447464730 | Mai Thanh Pham | Surgery | 1229 Madison St Suite # 1190, Seattle, WA 98104 | 2007-05-09 |
| 1659480630 | Ellen Lyman Thomason Derrick | Surgery | 3216 Ne 45th Pl Ste 207, Seattle, WA 98105-4028 | 2006-08-30 |
| 1366491045 | Kaj Johansen | Surgery | 600 Broadway Ste 112, Seattle, WA 98122-5381 | 2006-05-09 |
| 1568430908 | Swee Lian Tan | Surgery | 515 Minor Ave Ste 240, Seattle, WA 98104-2133 | 2006-03-10 |
| 1295730018 | Paul Gregory Hayes | Surgery | 801 Broadway Ste 500, Seattle, WA 98122-4396 | 2005-06-17 |
| 1184020307 | Usa Vein Clinics of Seattle, Pllc | Surgery | 10564 5th Ave Ne, Suite 102, Seattle, WA 98125-7200 | 2014-11-16 |
| 1942542212 | Matthew C Smith | Surgery | 1550 N 115th St, Seattle, WA 98133-8401 | 2013-03-25 |
| 1043579600 | Matthew Evans Bennett | Surgery | 1100 9th Ave, Seattle, WA 98101-2756 | 2012-05-16 |
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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.