Organization Active NPI

Urology Northwest, PS

  • Urology Physician
  • Mountlake Terrace, WA
National Provider Identifier
1124084983
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
UROLOGY NORTHWEST, PS
Practice address
6005 244TH St SW
Ste 111
Mountlake Terrace, WA 98043-5400
Phone
(425) 275-5555
Fax
(425) 275-5591
NPI assigned
Apr 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Candy S Chapman
Title
Administrator
Phone
(425) 275-5547

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

6005 244TH St SW
Ste 111
Mountlake Terrace, WA 98043-5400

Mailing address

6005 244TH St SW
Ste 111
Mountlake Terrace, WA 98043-5400
Phone (425) 275-5555

Other identifiers 4

IdentifierTypeStateIssuer
NO3976OtherWAKING COUNTY
7081094MedicaidWA
CE8230OtherWARAILROAD MEDICARE
105065OtherWALABOR AND INDUSTRIES

National Provider Directory

National Provider Directory

Locations

24360 Van Ry Blvd
Ste 113
Mountlake Terrace, WA 98043

24360 Van Ry Blvd
Ste 111
Mountlake Terrace, WA 98043
Phone (425) 275-5555

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1124084983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 244TH ST SW",
            "address_2": "STE 111",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435400",
            "telephone_number": "425-275-5555",
            "fax_number": "425-275-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 244TH ST SW",
            "address_2": "STE 111",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435400",
            "telephone_number": "425-275-5555",
            "fax_number": "425-275-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY NORTHWEST, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "CANDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "425-275-5547"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KING COUNTY",
            "identifier": "NO3976",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7081094",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE8230",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "105065",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.