Ralph J Mack, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD00023729 Issued in WA

Practice address

1201 S Miller St Ste a
Wenatchee, WA 98801-3201

Phone

(509) 663-8711

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1124044128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MILLER ST STE A",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013201",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "RALPH",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00023729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE WVH",
            "identifier": "P01256589",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124044128",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WVH LNI",
            "identifier": "315795",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Sasha Lundgren, MD
• Karen Kay Lynch, RN
• Lynn a. Madsen, Ma PS
• Richard Lynn, M.D.
• Jill Laverne Lyon, CDPT
• Sarah Elizabeth Mackay, M.D.
• Cynthia A Macklin, P.A.
• Stephanie Macon
• Kenzi Madland, RN
• Kerry September Madland, PA-C

• Cardiovascular Disease Physician in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Cardiovascular Disease Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.