Elmm Clinic

Primary specialty

Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X

License

MD60251426 Issued in WA

Legal business name

ELMM CLINIC

Practice address

1500 Commercial Ave
Anacortes, WA 98221-2235

Phone

(360) 399-7732

Fax

(724) 470-8032

NPI assigned

Apr 26, 2017

Organization subpart

No

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

Authorized official

Name

Debra Page

Title

Office Manager

Phone

(360) 420-6474

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1164957288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 COMMERCIAL AVE",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212235",
            "telephone_number": "360-399-7732",
            "fax_number": "724-470-8032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 COMMERCIAL AVE",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212235",
            "telephone_number": "360-399-7732",
            "fax_number": "724-470-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELMM CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-420-6474"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "WA",
            "license": "MD60251426",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SF0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holle Ann Edwards, SUDP
• Susan L Edwards, MSW, LICSW
• Nicolas Alfonso Elizondo
• Kenneth R Ellis, MD
• Michelle Matson Ellis, MACP
• Daniel Enselman, LMHC, CDP
• John W Fabianek, D.C.
• Family Care Network PLLC
• Family Care Network PLLC
• Family Care Network PLLC

• Obesity Medicine (Internal Medicine) Physician in Anacortes, WA
• Providers in Anacortes, WA by specialty
• Obesity Medicine (Internal Medicine) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.