Individual provider Active NPI

Rosemarie Ann Kennaley, MD

  • Family Medicine Physician
  • Bothell, WA
National Provider Identifier
1205082211
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.MD.70120368 Issued in WA
Practice address
1909 214TH St SE Ste 205
Bothell, WA 98021-4415
Phone
(425) 420-1657
Fax
(425) 420-1644
NPI assigned
Aug 9, 2008
Last updated
Jul 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.MD.70120368 WA Primary

Addresses

Primary practice location

1909 214TH St SE Ste 205
Bothell, WA 98021-4415

Mailing address

1728 W Marine View Dr Ste 110
Everett, WA 98201-2094
Phone (425) 259-4041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100511000400 AZ Practitioner - Family Practice 9335207943 Reassigns benefits to 2 organizations
I20160908000033 MT Practitioner - Family Practice 9335207943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
McMaster Un, Michael Degroote School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Institute of Medicine and SurgeryGroup PAC ID 0547155566, 3 clinicians
Aims Physicians and SurgeonsGroup PAC ID 6709770696, 7 clinicians

Practice addresses (Care Compare)

3636 N Stockton Hill Rd
Kingman, AZ 86409-0514
Phone (928) 757-3636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23812AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aims Physicians and Surgeons Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Logan Health - Conrad Current Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Aug 4, 2026 Accepting new patients
Logan Health - Conrad CurrentSince Sep 30, 2015 Accepting new patients
Logan Health - Conrad CurrentSince Sep 30, 2015 Accepting new patients
Livn, P.C. Family Medicine Past Accepting new patients
Western Washington Medical Group Inc PS Family Medicine PastSince Aug 4, 2026 Accepting new patients

Locations

3636 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-3636

809 Sunset Blvd
Conrad, MT 59425
Phone (406) 271-3211

1909 214th St SE
Ste 205
Bothell, WA 98021
Phone (425) 248-2626

1728 W Marine View Dr
Ste 110
Everett, WA 98201
Phone (425) 259-4041

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1218240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1205082211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 W MARINE VIEW DR STE 110",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012094",
            "telephone_number": "425-259-4041",
            "fax_number": "425-740-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 214TH ST SE STE 205",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214415",
            "telephone_number": "425-420-1657",
            "fax_number": "425-420-1644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNALEY",
        "first_name": "ROSEMARIE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-09",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD.MD.70120368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

Verify at the official NPI Registry.