Active NPI
William B Gunderson IV, MD
- Internal Medicine Physician
- Friday Harbor, WA
National Provider Identifier
1205151990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD60476325
- Practice address
- 1117 Spring St
Friday Harbor, WA 98250-9782 - Phone
- (360) 378-2141
- Fax
- (360) 378-1785
- NPI assigned
- Apr 6, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | MD60476325 | WA | Primary |
Addresses
Primary practice location
1117 Spring St
Friday Harbor, WA 98250-9782
Mailing address
220 NW 49TH St
Seattle, WA 98107-3417
Phone (503) 791-2709
Other practice location 1
3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone (503) 494-8211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Tulane University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Peacehealth
Practice addresses (Care Compare)
1117 Spring St
Friday Harbor, WA 98250-9782
Phone (360) 378-2141
Hospital & facility affiliations
- Alpha Home Health
- Hospice of the Northwest
- Peacehealth Peace Island Medical Center
- Island Hospital
- Peacehealth United General Medical Center
- Peacehealth St Joseph Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60476325 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peacehealth | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients | |
| Peacehealth | Current | Accepting new patients |
Locations
1117 Spring St
Friday Harbor, WA 98250
Phone (360) 378-1738
Interoperability endpoints
- wgunderson62786@direct.peacehealth.org
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Friday Harbor, WA
- NPI 1902232507
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Everett, WA
- NPI 1518482215
-
- General Acute Care Hospital
- Anacortes, WA
- NPI 1710913140
Hospital
-
- Community Based Hospice Care Agency
- Mount Vernon, WA
- NPI 1174693139
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1205151990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 NW 49TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981073417",
"telephone_number": "503-791-2709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1117 SPRING ST",
"city": "FRIDAY HARBOR",
"state": "WA",
"postal_code": "982509782",
"telephone_number": "360-378-2141",
"fax_number": "360-378-1785"
}
],
"practiceLocations": [
{
"address_1": "3181 SW Sam Jackson Park Rd",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972393011",
"country_code": "US",
"telephone_number": "503-494-8211",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUNDERSON",
"first_name": "WILLIAM",
"middle_name": "B",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-06",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD60476325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Friday Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.