NPIMap

Organization Active NPI

Amen Clinics Inc, Bellevue

  • Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
  • Tukwila, WA
National Provider Identifier
1124149851
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Neuroimaging (Psychiatry & Neurology) PhysicianTaxonomy code 2084D0003X
Legal business name
AMEN CLINICS INC, BELLEVUE
Practice address
545 Andover Park W Ste 101
Tukwila, WA 98188-3347
Phone
(425) 455-7500
Fax
(425) 454-7845
NPI assigned
Apr 2, 2007
Last updated
Jan 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
AMEN CLINICS, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Christina T McCormick, MS
Title
Data Systems Specialist
Phone
(703) 880-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician 2084D0003X Primary

Addresses

Primary practice location

545 Andover Park W Ste 101
Tukwila, WA 98188-3347

Mailing address

545 Andover Park W Ste 101
Tukwila, WA 98188-3347
Phone (425) 455-7500

Other names 1

  • Amen Clinic Northwest Other name

National Provider Directory

National Provider Directory
Tax ID family
Amen Clinics Inc Dallas11 organizations share this tax ID, including this one
Part of
Amen Clinics Inc Dallas

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4019 Westerly Pl
Ste 100
Newport Beach, CA 92660
Phone (949) 266-3700

616 120th Ave NE
Ste C100
Bellevue, WA 98005
Phone (425) 454-7845

3315 S 23rd St
Ste 102
Tacoma, WA 98405
Phone (253) 345-5720

545 Andover Park W
Ste 101
Tukwila, WA 98188
Phone (425) 455-7500

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1124149851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 ANDOVER PARK W STE 101",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981883347",
            "telephone_number": "425-455-7500",
            "fax_number": "253-779-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 ANDOVER PARK W STE 101",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981883347",
            "telephone_number": "425-455-7500",
            "fax_number": "425-454-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMEN CLINICS INC, BELLEVUE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMEN CLINICS, INC",
        "enumeration_date": "2007-04-02",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DATA SYSTEMS SPECIALIST",
        "authorized_official_telephone_number": "703-880-4000",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "2084D0003X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amen Clinic Northwest",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Amen Clinic Northwest",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.