Organization Active NPI

Wasea Medical LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Seattle, WA
National Provider Identifier
1174787667
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD00046227 Issued in WA
Legal business name
WASEA MEDICAL LLC
Practice address
1400 S Jackson St Ste 24
Seattle, WA 98144
Phone
(206) 568-8577
NPI assigned
Jul 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

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

Authorized official

Name
Jiegang Yang Zhou, M.D.NPI 1538109525
Title
President
Phone
(206) 331-4005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X MD00046227 WA Primary

Addresses

Primary practice location

1400 S Jackson St Ste 24
Seattle, WA 98144

Mailing address

11707 Exeter Ave NE
Seattle, WA 98125-5913
Phone (206) 568-8577

Other practice location 1

3521 NE 93rd St
Seattle, WA 98115-3663
Phone (206) 331-4005

Other practice location 2

3521 NE 93rd St
Seattle, WA 98115-3663
Phone (206) 331-4005

Other practice location 3

11707 Exeter Ave NE
Seattle, WA 98125
Phone (206) 568-8577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080807000258 WA Part B Supplier - Clinic/Group Practice 7113091281 Receives reassigned benefits from 1 practitioner
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Locations

1400 S Jackson St
Ste 24
Seattle, WA 98144
Phone (206) 568-8577

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": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541980800000",
    "number": "1174787667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11707 EXETER AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981255913",
            "telephone_number": "206-568-8577",
            "fax_number": "206-568-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S JACKSON ST STE 24",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98144",
            "telephone_number": "206-568-8577"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3521 NE 93rd St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981153663",
            "country_code": "US",
            "telephone_number": "206-331-4005",
            "fax_number": "206-568-3385",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3521 NE 93rd St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981153663",
            "country_code": "US",
            "telephone_number": "206-331-4005",
            "fax_number": "206-568-3385",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11707 Exeter Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98125",
            "country_code": "US",
            "telephone_number": "206-568-8577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WASEA MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2018-11-12",
        "status": "A",
        "authorized_official_last_name": "ZHOU",
        "authorized_official_first_name": "JIEGANG",
        "authorized_official_middle_name": "YANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-331-4005",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "MD00046227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.