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WESTERN WASHINGTON MEDICAL GROUP NPI 1194045542


NPI Information

NPI: 1194045542
Provider Name: WESTERN WASHINGTON MEDICAL GROUP
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 50D0855712

Address:
1909 214TH ST SE
SUITE 211
BOTHELL, WA
ZIP 98021
Phone: (425) 420-1655
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WESTERN WASHINGTON MEDICAL GROUP is a specialist in Bothell, WA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. WESTERN WASHINGTON MEDICAL GROUP NPI is 1194045542. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1909 214TH ST SE
SUITE 211
BOTHELL, WA
ZIP 98021-412
Phone: (425) 420-1655

The provider's authorized official is Jerome Tillinger .
The authorized official title is Ceo and has the following contact phone number (425) 259-4041.

The CLIA number assigned to this NPI record is 50D0855712 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/8/2010 and was last updated on 11/23/2011.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine207R00000XWASHINGTONNo
2174400000XSpecialist207RG0100XWASHINGTONNo
3174400000XSpecialist207RC0000XWASHINGTONNo
4174400000XSpecialist213E00000XWASHINGTONNo
5174400000XSpecialist207Y00000XWASHINGTONNo
6174400000XSpecialist291U00000XWASHINGTONNo
7174400000XSpecialist207RE0101XWASHINGTONYes

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: 5/5/2024

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.