| Western Washington Medical Group, Inc Ps | |
|
12728 19th Ave Se Ste 300 Everett WA 98208-6526 | |
| (425) 252-1116 | |
| Not Available |
| Full Name | Western Washington Medical Group, Inc Ps |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12728 19th Ave Se Ste 300, Everett, Washington |
| Authorized Official Name and Position | Kimberly Holstein (DIRECTOR CORPORATE COMPLIANCE) |
| Authorized Official Contact | 4252594041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Washington Medical Group, Inc Ps 1728 W Marine View Dr Ste 110 Everett WA 98201-2094 Ph: (425) 259-4041 | Western Washington Medical Group, Inc Ps 12728 19th Ave Se Ste 300 Everett WA 98208-6526 Ph: (425) 252-1116 |
| NPI Number | 1396413803 |
|---|---|
| Provider Enumeration Date | 08/31/2021 |
| Last Update Date | 08/31/2021 |
| Certification Date | 08/31/2021 |
| Medicare PECOS PAC ID | 7517870314 |
|---|---|
| Medicare Enrollment ID | O20031107000469 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396413803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Khaled Abdel-rahman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1881731370 PECOS PAC ID: 7911811815 Enrollment ID: I20031114000576 |
| Provider Name | Sarosh F Siddiqi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1225175714 PECOS PAC ID: 2668362229 Enrollment ID: I20040317000978 |
| Provider Name | Howard M Aposhyan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407802507 PECOS PAC ID: 1355334707 Enrollment ID: I20040403000193 |
| Provider Name | Mark E Gunning |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1255388914 PECOS PAC ID: 0840182622 Enrollment ID: I20040412001590 |
| Provider Name | George W Moore |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1588604110 PECOS PAC ID: 6800884354 Enrollment ID: I20040504000071 |
| Provider Name | Tomasz M Ziedalski |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1265473854 PECOS PAC ID: 8426039520 Enrollment ID: I20040623000672 |
| Provider Name | Jeff R Peterson |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1467491076 PECOS PAC ID: 3779556725 Enrollment ID: I20040817001229 |
| Provider Name | April L Wolanek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518988542 PECOS PAC ID: 3678549144 Enrollment ID: I20040907000463 |
| Provider Name | David O Lindstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902852569 PECOS PAC ID: 3870554173 Enrollment ID: I20041020000812 |
| Provider Name | Julie R Wood-mcclure |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962459719 PECOS PAC ID: 5496741456 Enrollment ID: I20041119000733 |
| Provider Name | David A Russian |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1376582981 PECOS PAC ID: 0042275414 Enrollment ID: I20041124000585 |
| Provider Name | Stephen P Woods |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598722423 PECOS PAC ID: 7416933866 Enrollment ID: I20050802001275 |
| Provider Name | Ann K Begert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538265103 PECOS PAC ID: 1052343928 Enrollment ID: I20050831000727 |
| Provider Name | Robin L Madsen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972550556 PECOS PAC ID: 0446283758 Enrollment ID: I20050916000608 |
| Provider Name | Lisa A Adriance |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235186917 PECOS PAC ID: 3971521238 Enrollment ID: I20051104000291 |
| Provider Name | Lisa D Biehl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376622852 PECOS PAC ID: 0143243550 Enrollment ID: I20060112000045 |
| Provider Name | David W Janeway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821177437 PECOS PAC ID: 8426071945 Enrollment ID: I20060112000051 |
| Provider Name | James R Fletcher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407935091 PECOS PAC ID: 6608899125 Enrollment ID: I20060112000070 |
| Provider Name | Brent G Thiel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811093958 PECOS PAC ID: 4688689102 Enrollment ID: I20060220000390 |
| Provider Name | Richard A Jimenez |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1366484040 PECOS PAC ID: 9436043940 Enrollment ID: I20060314000208 |
| Provider Name | Andrew K Solomon |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1588607808 PECOS PAC ID: 3072541945 Enrollment ID: I20060314000220 |
| Provider Name | Michael H Duong |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1043256803 PECOS PAC ID: 7618970922 Enrollment ID: I20060804000318 |
| Provider Name | Andrea L Friesen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750374799 PECOS PAC ID: 5496857351 Enrollment ID: I20070222000763 |
| Provider Name | Victor Henry Gajewski |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164451225 PECOS PAC ID: 3678552841 Enrollment ID: I20070403000437 |
| Provider Name | Donald E Wakelin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790820546 PECOS PAC ID: 5193825982 Enrollment ID: I20070709000475 |
| Provider Name | Marcus C Lien |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1063439941 PECOS PAC ID: 9638175714 Enrollment ID: I20070717000660 |
| Provider Name | Jose M Mata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346227170 PECOS PAC ID: 3375586910 Enrollment ID: I20070914000092 |
| Provider Name | Chad A Warren |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235244054 PECOS PAC ID: 8123098068 Enrollment ID: I20071005000078 |
| Provider Name | Meghann M Moore |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1982878237 PECOS PAC ID: 7810076817 Enrollment ID: I20080501000569 |
| Provider Name | Susana J Escobar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891896262 PECOS PAC ID: 3870662216 Enrollment ID: I20080527000396 |
| Provider Name | Erin M Robinson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1437273034 PECOS PAC ID: 6103991690 Enrollment ID: I20080818000737 |
| Provider Name | Anita E Tsen |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1235159047 PECOS PAC ID: 3072510585 Enrollment ID: I20080904000254 |
| Provider Name | Bridgit Bell |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1063525426 PECOS PAC ID: 2264482868 Enrollment ID: I20080916000665 |
| Provider Name | Lee A Kearns |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902071574 PECOS PAC ID: 8628146347 Enrollment ID: I20081008000560 |
| Provider Name | Albert F Yuen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902997638 PECOS PAC ID: 9931262821 Enrollment ID: I20090121000143 |
| Provider Name | Joyce E Burt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336393222 PECOS PAC ID: 4688738925 Enrollment ID: I20090130000401 |
| Provider Name | Karen S Bloom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144469099 PECOS PAC ID: 5496802217 Enrollment ID: I20090414000576 |
| Provider Name | James Z Mu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841231438 PECOS PAC ID: 5698869261 Enrollment ID: I20090416000063 |
| Provider Name | Sujoy K Ghorai |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386680445 PECOS PAC ID: 3870687445 Enrollment ID: I20090416000091 |
| Provider Name | Eric R Martinez |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1023295615 PECOS PAC ID: 7113074709 Enrollment ID: I20090420000043 |
| Provider Name | Andrew R Kruse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316128622 PECOS PAC ID: 7214085497 Enrollment ID: I20090427000498 |
| Provider Name | Matthew N Ashbach |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1073753661 PECOS PAC ID: 8426107855 Enrollment ID: I20090514000244 |
| Provider Name | Robert H Mccoy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1326034042 PECOS PAC ID: 4688719545 Enrollment ID: I20100303000154 |
| Provider Name | William Douglas Trotter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336163351 PECOS PAC ID: 1759405855 Enrollment ID: I20100826000241 |
| Provider Name | Ya Lan Huang |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1013957661 PECOS PAC ID: 5395869267 Enrollment ID: I20100830000233 |
| Provider Name | James M Schmitt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023058229 PECOS PAC ID: 0840315255 Enrollment ID: I20100908000964 |
| Provider Name | Laura A Paulsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952325979 PECOS PAC ID: 4880719939 Enrollment ID: I20100914000385 |
| Provider Name | Andrew S Sohn |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1215977897 PECOS PAC ID: 4587746979 Enrollment ID: I20101006000527 |
| Provider Name | Harold G Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831194745 PECOS PAC ID: 6305841131 Enrollment ID: I20101007001289 |
| Provider Name | Tuyen M Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255545786 PECOS PAC ID: 3870785835 Enrollment ID: I20101008000308 |
| Provider Name | Friedrich C Loura |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760423388 PECOS PAC ID: 0941498000 Enrollment ID: I20101216000511 |
| Provider Name | Edward A Slosberg |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740227982 PECOS PAC ID: 2769670264 Enrollment ID: I20101228000692 |
| Provider Name | Jeffrey W Boggs |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1457391088 PECOS PAC ID: 7113024035 Enrollment ID: I20110131000243 |
| Provider Name | Seth D Hartung |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043337751 PECOS PAC ID: 5799965422 Enrollment ID: I20110211000536 |
| Provider Name | Stephanie Shoemaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619108438 PECOS PAC ID: 0345378683 Enrollment ID: I20110317000416 |
| Provider Name | Valerie K Eckley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811901572 PECOS PAC ID: 1052595220 Enrollment ID: I20110420000252 |
| Provider Name | Kari L Ketner |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720371768 PECOS PAC ID: 6709055874 Enrollment ID: I20110805000263 |
| Provider Name | Eduardo A Chua |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760694186 PECOS PAC ID: 7517138860 Enrollment ID: I20110919000513 |
| Provider Name | Courtney Amanda Clinton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083847883 PECOS PAC ID: 0042474017 Enrollment ID: I20120605000012 |
| Provider Name | Vince N Montes |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1841266285 PECOS PAC ID: 6709789993 Enrollment ID: I20120731000676 |
| Provider Name | Evelyn J Reilly |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992061568 PECOS PAC ID: 4284880634 Enrollment ID: I20120820000003 |
| Provider Name | Sejal P Graber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043538440 PECOS PAC ID: 3971750233 Enrollment ID: I20120822000232 |
| Provider Name | Karen S Myren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508092784 PECOS PAC ID: 7214184647 Enrollment ID: I20130313000280 |
| Provider Name | Joshua Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063405017 PECOS PAC ID: 4082863782 Enrollment ID: I20130530000548 |
| Provider Name | Jessica Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780643973 PECOS PAC ID: 5890933949 Enrollment ID: I20130530000583 |
| Provider Name | Michael Daniel Liang |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1669675872 PECOS PAC ID: 8729221650 Enrollment ID: I20130826000310 |
| Provider Name | Kathryn A Sawyer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841633534 PECOS PAC ID: 8022252394 Enrollment ID: I20130926000722 |
| Provider Name | Maiyen T Hawkins |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841446655 PECOS PAC ID: 6709012693 Enrollment ID: I20131125000818 |
| Provider Name | Alireza K Anissipour |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033352968 PECOS PAC ID: 4789808692 Enrollment ID: I20140616002270 |
| Provider Name | Joshua H Urvater |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558316703 PECOS PAC ID: 4587668785 Enrollment ID: I20140902001423 |
| Provider Name | Donald Henline |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356326870 PECOS PAC ID: 8022179241 Enrollment ID: I20140908002705 |
| Provider Name | Rebecca Epperson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710396387 PECOS PAC ID: 5294956991 Enrollment ID: I20141022000721 |
| Provider Name | Justin R Cuschieri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871787663 PECOS PAC ID: 6709063720 Enrollment ID: I20141120002559 |
| Provider Name | Brad Thomas Tyson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952704413 PECOS PAC ID: 7113249418 Enrollment ID: I20141121002014 |
| Provider Name | Elizabeth Hsu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922312479 PECOS PAC ID: 5496063059 Enrollment ID: I20150930002521 |
| Provider Name | Kristen B Boyce |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1407906324 PECOS PAC ID: 8729176870 Enrollment ID: I20151006003132 |
| Provider Name | Wesleigh Robin Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396119285 PECOS PAC ID: 4284931395 Enrollment ID: I20160404001792 |
| Provider Name | Phillip Andrew Shaw |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1447593256 PECOS PAC ID: 2466752738 Enrollment ID: I20160620001953 |
| Provider Name | Jamie R Litvack |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1487809703 PECOS PAC ID: 3173772720 Enrollment ID: I20160812000710 |
| Provider Name | Catherine Jade Yee |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1619264009 PECOS PAC ID: 6800183849 Enrollment ID: I20160920000526 |
| Provider Name | Ronald Joseph Quam |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306908033 PECOS PAC ID: 0941367478 Enrollment ID: I20160922001296 |
| Provider Name | Corinne Spero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184171563 PECOS PAC ID: 7810285640 Enrollment ID: I20161011003180 |
| Provider Name | Nathan Parker |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1013232560 PECOS PAC ID: 7012225642 Enrollment ID: I20161130002005 |
| Provider Name | Ann Marie B Schreiber |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376863050 PECOS PAC ID: 1052631694 Enrollment ID: I20161202000479 |
| Provider Name | Rajani Samyuktha Krishna |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1134586746 PECOS PAC ID: 1153602370 Enrollment ID: I20161230001719 |
| Provider Name | Kent Blakely |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1134222458 PECOS PAC ID: 8325069685 Enrollment ID: I20170126001340 |
| Provider Name | Elizabeth A Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952844987 PECOS PAC ID: 1254615479 Enrollment ID: I20170306002772 |
| Provider Name | Breanne Van Voast |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780131672 PECOS PAC ID: 0143501585 Enrollment ID: I20170627000556 |
| Provider Name | Sumangala Vasudevan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1497083265 PECOS PAC ID: 8921254814 Enrollment ID: I20170713003332 |
| Provider Name | Ashley R Snyder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053726885 PECOS PAC ID: 9436376696 Enrollment ID: I20170815000969 |
| Provider Name | Suzanne M Gisch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619407467 PECOS PAC ID: 8224303219 Enrollment ID: I20170929003270 |
| Provider Name | Jessica L Bluto |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1457761678 PECOS PAC ID: 2769797521 Enrollment ID: I20171023001570 |
| Provider Name | Francisco J Perez Mata |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1407142664 PECOS PAC ID: 8628351319 Enrollment ID: I20180814000474 |
| Provider Name | Tyler Kent |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336439116 PECOS PAC ID: 3375892730 Enrollment ID: I20180817000635 |
| Provider Name | Victoria Leona Longstreth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366927253 PECOS PAC ID: 7810234036 Enrollment ID: I20190125002790 |
| Provider Name | Niket Nathani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801113154 PECOS PAC ID: 3173760725 Enrollment ID: I20190621000949 |
| Provider Name | Abigail Denise Doyle |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1861755498 PECOS PAC ID: 0345462305 Enrollment ID: I20190621001227 |
| Provider Name | Eugene Shchytou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063074169 PECOS PAC ID: 3678800596 Enrollment ID: I20190814003072 |
| Provider Name | Christi A Emmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124689237 PECOS PAC ID: 8325378482 Enrollment ID: I20191002003895 |
| Provider Name | Amaleswari Pamarthy |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1265745459 PECOS PAC ID: 5193975753 Enrollment ID: I20191115000804 |
| Provider Name | Justin Samuel Hampton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245758903 PECOS PAC ID: 1658705819 Enrollment ID: I20191220000812 |
| Provider Name | Kathleen Shay |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497850051 PECOS PAC ID: 4789669524 Enrollment ID: I20200516000069 |
| Provider Name | Rafael C Wabl |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467803700 PECOS PAC ID: 5698068054 Enrollment ID: I20200518002932 |
| Provider Name | Christina M Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386279149 PECOS PAC ID: 0446672851 Enrollment ID: I20200611002570 |
| Provider Name | Matthew Baron |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487074142 PECOS PAC ID: 8628392396 Enrollment ID: I20200727002036 |
| Provider Name | Reema Jayakar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790394690 PECOS PAC ID: 5799196986 Enrollment ID: I20201118003334 |
| Provider Name | Michelle C Percopo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649883810 PECOS PAC ID: 2860805306 Enrollment ID: I20201230001694 |
| Provider Name | Jesseca Wang Eskander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184265316 PECOS PAC ID: 4587070594 Enrollment ID: I20210316002581 |
| Provider Name | Lindsay D R Kraemer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487013397 PECOS PAC ID: 6901213735 Enrollment ID: I20210323002619 |
| Provider Name | Valerie A Brand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609464676 PECOS PAC ID: 1355759416 Enrollment ID: I20210409002034 |
| Provider Name | Terrell J Harrington |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487231684 PECOS PAC ID: 2860892528 Enrollment ID: I20210617000368 |
| Provider Name | Mikaela A Guimaraes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396310835 PECOS PAC ID: 4981005196 Enrollment ID: I20210625000683 |
| Provider Name | Maxwell M Zamzow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326618281 PECOS PAC ID: 9638572597 Enrollment ID: I20210729001972 |
| Provider Name | Tiyanna C Rodgers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770101396 PECOS PAC ID: 9638573371 Enrollment ID: I20210803002389 |
| Provider Name | Thiago Jabuonski |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1053685107 PECOS PAC ID: 0941596423 Enrollment ID: I20210924001940 |
| Provider Name | Umar S Mohammed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396238911 PECOS PAC ID: 7214269778 Enrollment ID: I20211209002914 |
| Provider Name | Shirin Schilling |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043573272 PECOS PAC ID: 2062707201 Enrollment ID: I20211227000109 |
| Provider Name | Makambo Tshionyi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659782985 PECOS PAC ID: 7719277532 Enrollment ID: I20211230001386 |
| Provider Name | Phillip Kenneth Gregoire |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073268827 PECOS PAC ID: 0244611374 Enrollment ID: I20220720001031 |
| Provider Name | Carolyn M Freed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962495929 PECOS PAC ID: 6608170246 Enrollment ID: I20220809000041 |
| Provider Name | Andrew Huang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144753039 PECOS PAC ID: 3678842945 Enrollment ID: I20220816003455 |
| Provider Name | Stephanie Chauchi Kuo Su |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942869136 PECOS PAC ID: 0749516490 Enrollment ID: I20221005003055 |
| Provider Name | Emilyn Katherine Weiss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144941501 PECOS PAC ID: 5799151379 Enrollment ID: I20221024000675 |
| Provider Name | Kanchana D Allan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215676853 PECOS PAC ID: 1759758865 Enrollment ID: I20221102002113 |
| Provider Name | Lindsey Ann Wolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518621051 PECOS PAC ID: 9739579137 Enrollment ID: I20221206001925 |
| Provider Name | Sarah Gattis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497472815 PECOS PAC ID: 6507238938 Enrollment ID: I20230214000534 |
| Provider Name | Yunet Solorzano |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1982052536 PECOS PAC ID: 2769777432 Enrollment ID: I20230608001298 |
| Provider Name | Nathaniel Elliot Schaffer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679001747 PECOS PAC ID: 5193086304 Enrollment ID: I20230908003258 |
| Provider Name | Bridget Marie Noorishad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073295143 PECOS PAC ID: 9436506862 Enrollment ID: I20231107002445 |
| Provider Name | Judy Thi Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376324368 PECOS PAC ID: 5890147813 Enrollment ID: I20240116001013 |
Sunrise Services, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1718 Broadway, Everett, WA 98201 Phone: 425-595-5200 Fax: 425-595-5201 | |
Northwest Neurology & Sleep Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10315 19th Ave Se, Ste 112, Everett, WA 98208 Phone: 425-379-7191 Fax: 425-379-8271 | |
Western Washington Medical Group, Inc Ps Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1728 W Marine View Dr, Suite 110, Everett, WA 98201 Phone: 425-259-4041 Fax: 425-252-6642 | |
Providence Health & Services-wa Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1321 Colby Ave, Everett, WA 98201 Phone: 425-261-3968 Fax: 425-261-3967 | |
Bridgeways Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5801 23rd Dr W, 104, Everett, WA 98203 Phone: 425-513-8213 | |
Eleanor Health Professional Wa, Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 4310 Colby Ave Ste 201, Everett, WA 98203 Phone: 866-323-2596 | |
Quality Counseling And Consultation Service Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2723 Leonard Dr, Everett, WA 98201 Phone: 206-705-9479 Fax: 206-219-0456 |