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WESTERN WASHINGTON MEDICAL GROUP INC PS NPI 1417175811


NPI Information

NPI: 1417175811
Provider Name: WESTERN WASHINGTON MEDICAL GROUP, INC PS

Doing Business As: WESTERN WA MEDICAL GROUP DEPT OF NEPHROLOGY

Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
1330 ROCKEFELLER AVE STE 450
EVERETT, WA
ZIP 98201
Phone: (425) 258-6801
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WESTERN WASHINGTON MEDICAL GROUP, INC PS is a nephrology internal medicine in Everett, WA. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. WESTERN WASHINGTON MEDICAL GROUP, INC PS NPI is 1417175811. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Western Wa Medical Group Dept Of Nephrology.

The provider's business location address is:

1330 ROCKEFELLER AVE STE 450
EVERETT, WA
ZIP 98201-677
Phone: (425) 258-6801
Fax: (425) 258-1944

The provider's authorized official is Vicki Mcginnis .
The authorized official title is Hippa Privacy Officer and has the following contact phone number (425) 259-4041.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 2/23/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RN0300XInternal MedicineNephrology601474013WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1115100400MEDICARE PINWASHINGTON
2CJ9333OTHERWASHINGTONRAILROAD MEDICARE
37057029MEDICAIDWASHINGTON
40050081OTHERWASHINGTONLABOR & INDUSTRY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.