Madrona Family Medicine, PS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00031142 Issued in WA

Legal business name

MADRONA FAMILY MEDICINE, PS

Practice address

740 Quincy St
Port Townsend, WA 98368-5525

Phone

(360) 440-6220

NPI assigned

Jul 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Wallace Stowe, M.D.NPI 1306990718

Title

President

Phone

(360) 440-6220

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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

• Bruce W Stowe, MD

  • Family Medicine Physician
  • Port Townsend, WA
  • NPI 1306990718
  NPD (past) Authorized official
• Sandra Vanvig, ARNP

  • Family Nurse Practitioner
  • Port Townsend, WA
  • NPI 1114073301
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378425600000",
    "number": "1154528156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1212",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983680912",
            "telephone_number": "360-440-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 QUINCY ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983685525",
            "telephone_number": "360-440-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRONA FAMILY MEDICINE, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2013-09-06",
        "status": "A",
        "authorized_official_last_name": "STOWE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "WALLACE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-440-6220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00031142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8232886",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly D Macintosh, RN
• Mary Jo Mackenzie, R.N.
• Jessica Erin Mackinnon, PH.D
• Holly Maclean, LAC
• Emily N Madden I, LMT
• Madrona Hill Urgent Care, LLC
• Madrona Institute of Washington
• Frank B Magill Jr., M.D.
• Lisa Marks Mahon
• Bradley Maier

• Family Medicine Physician in Port Townsend, WA
• Providers in Port Townsend, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2013; 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.