WESTERN WASHINGTON MEDICAL GROUP (NPI# 1851710495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851710495 |
| Entity Type | Organization |
| Organization Name | WESTERN WASHINGTON MEDICAL GROUP |
| Practice Address |
12728 19th Ave Se Suite 200 Everett WA 98208-6526 |
| Practice Telephone | 4252252760 |
| Practice Fax Number | 4252521118 |
| Mailing Telephone | 4252252760 |
| Mailing Fax Number | 4252521118 |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2014-04-10 |
| Authorized Official Name | DR. STEPHANIE E ABBOTT (RESEARCH DIRECTOR) |
| Authorized Official Telephone | 4252252760 |
| Authorized Official Credential | PHARM D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PH00020716 | WA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | PHARMACIST LICENSE | PH00020716 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225256720 | Western Washington Medical Group | Surgery | 3216 Norton Ave Ste 202, Everett, WA 98201-4290 | 2007-04-23 |
| 1194045542 | Western Washington Medical Group | Internal Medicine | 1909 214th St Se, Suite 211, Bothell, WA 98021-4412 | 2010-06-08 |
| 1013135417 | Western Washington Medical Group | Internal Medicine | 1717 13th St, Suite 300, Everett, WA 98201 | 2007-04-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | 1728 W Marine View Dr Ste 110, Everett, WA 98201-2094 |
| Street Address |
12728 19TH AVE SE SUITE 200 |
| City | EVERETT |
| State | WA |
| Zip Code | 98208-6526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780643973 | Jessica Susan Webb | Nurse Practitioner | 12728 19th Ave Se, Suite 300, Everett, WA 98208-6526 | 2006-03-17 |
| 1366927253 | Victoria Leona Longstreth | Nurse Practitioner | 12728 19th Ave Se, Everett, WA 98208-6526 | 2018-09-26 |
| 1568916682 | Western Washington Medical Group, Inc Ps | Psychiatry & Neurology | 12728 19th Ave Se, Suite 300, Everett, WA 98208-6526 | 2016-08-05 |
| 1457793390 | Bariatric Surgery Clinic Trust | Surgery | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2013-07-19 |
| 1093064263 | Evelyn Woods | Dietitian, Registered | 12728 19th Ave Se, Suite 300, Everett, WA 98208-6526 | 2012-09-04 |
| 1568747012 | Jason Anthony Talavera | Internal Medicine | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2011-10-17 |
| 1477847606 | Western Washington Cardiology Tr | Internal Medicine | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2011-06-06 |
| 1114217510 | Western Washington Cardiology Tr | Internal Medicine | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2011-04-19 |
| 1770727307 | Jillian K Hamel | Nurse Practitioner | 12728 19th Ave Se, Ste 200, Everett, WA 98208-6526 | 2009-04-27 |
| 1447423017 | Andrea Vitello | Internal Medicine | 12728 19th Ave Se, Everett, WA 98208-6526 | 2008-04-03 |
| 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 | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770876492 | Hiromi Truong | Pharmacist | 12800 Bothell Everett Hwy Ste 140, Everett, WA 98208-6642 | 2011-05-27 |
| 1679992903 | Stephanie Abbott | Pharmacist | 12728 19th Ave Se Ste 200, Everett, WA 98208-6526 | 2014-04-15 |
| 1184917023 | John Leon Somers | Pharmacist | 3305 Nassau St # 101, Everett, WA 98201-4140 | 2011-05-25 |
| 1336432350 | Michael J Mashock | Pharmacist | 3305 Nassau St, Everett, WA 98201-4140 | 2011-05-24 |
| 1851697221 | Trang Van Le | Pharmacist | 3305 Nassau St, Everett, WA 98201-4140 | 2011-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395760 | Evelyn Tong | Pharmacist | 4229 122nd Ave Se, Bellevue, WA 98006-1915 | 2020-10-29 |
| 1356985345 | Nancy Celine Tran | Pharmacist | 906 S 38th Ct, Renton, WA 98055-5897 | 2019-11-01 |
| 1265087654 | Valorie Swensen | Pharmacist | 4500 Harrison St, Bellingham, WA 98229-3323 | 2019-08-02 |
| 1982110805 | Derek Matlock | Pharmacist | 3715 Ocean Beach Hwy # 2, Longview, WA 98632-4801 | 2017-12-15 |
| 1659880938 | Hazel Ann Feist | Pharmacist | 14406 Nw 20th Ave, Vancouver, WA 98685-8007 | 2017-09-29 |
| 1528586732 | Mayumi Robbins | Pharmacist | 410 9th Ave N Fl 7, Seattle, WA 98109-4708 | 2017-09-07 |
| 1699293688 | Jin Man Choe | Pharmacist | 105 W 8th Ave Ste 350, Spokane, WA 99204-2312 | 2017-08-30 |
| 1821457813 | Marie Cermak | Pharmacist | 12333 Ne 130th Ln # Lane415, Kirkland, WA 98034-7467 | 2016-02-18 |
| 1902281959 | Carmen Joy Berg | Pharmacist | 2320 South Salnave Road, Medical Lake, WA 99022 | 2015-07-20 |
| 1639574981 | Loi Chau | Pharmacist | 601 Broadway Rm 117, Seattle, WA 98122-5330 | 2014-10-29 |
| Find all providers with the same taxonomy | ||||
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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.