| Swedish Edmonds | |
|
21601 76th Ave W Edmonds WA 98026-7507 | |
| (425) 640-4000 | |
| (425) 640-4455 |
| Full Name | Swedish Edmonds |
|---|---|
| Speciality | Internal Medicine |
| Location | 21601 76th Ave W, Edmonds, Washington |
| Authorized Official Name and Position | Donald Wayne Anderson (ASSISTANT SECREATRY FOR ENROLLMENT) |
| Authorized Official Contact | 4253589786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Swedish Edmonds Po Box 84026 Seattle WA 98124-8426 Ph: (425) 673-3374 | Swedish Edmonds 21601 76th Ave W Edmonds WA 98026-7507 Ph: (425) 640-4000 |
| NPI Number | 1588970909 |
|---|---|
| Provider Enumeration Date | 08/23/2010 |
| Last Update Date | 05/08/2025 |
| Certification Date | 05/08/2025 |
| Medicare PECOS PAC ID | 6305031931 |
|---|---|
| Medicare Enrollment ID | O20101203001023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588970909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Primary |
| Provider Name | Lovelle O Ralls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538150800 PECOS PAC ID: 5193742203 Enrollment ID: I20090922000774 |
| Provider Name | Sally W Echols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477690386 PECOS PAC ID: 3274436696 Enrollment ID: I20170929003211 |
| Provider Name | Denise Krackenberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316101082 PECOS PAC ID: 6406998772 Enrollment ID: I20221024000182 |
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