Cherry Heights Family Medicine of Washington

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CHERRY HEIGHTS FAMILY MEDICINE OF WASHINGTON

Practice address

1861 Claret Loop NW
Poulsbo, WA 98370-8380

Phone

(208) 650-4888

NPI assigned

Jun 17, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Cody Freston

Title

Owner

Phone

(208) 985-2260

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1013750082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 N CRESTMONT DR STE A",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422178",
            "telephone_number": "208-650-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1861 CLARET LOOP NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708380",
            "telephone_number": "208-650-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY HEIGHTS FAMILY MEDICINE OF WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "FRESTON",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-985-2260",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Poulsbo, WA
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• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.