Washington Otology Neurotology Group, P.S.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD000010422 Issued in WA

Legal business name

WASHINGTON OTOLOGY NEUROTOLOGY GROUP, P.S.

Practice address

901 Boren Ave
Suite 711
Seattle, WA 98104-3595

Phone

(206) 622-6987

NPI assigned

Apr 23, 2008

Organization subpart

Yes

Parent organization

WASHINGTON OTOLOGY NEUROTOLOGY GROUP, P.SAs reported in NPPES

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

Authorized official

Name

Pam Stanfill

Title

Manager

Phone

(253) 223-0515

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

Washington Otology Neurotology Group PS

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219968000000",
    "number": "1245405950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BOREN AVE",
            "address_2": "SUITE 711",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043595",
            "telephone_number": "206-622-6987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BOREN AVE",
            "address_2": "SUITE 711",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043595",
            "telephone_number": "206-622-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON OTOLOGY NEUROTOLOGY GROUP, P.S.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WASHINGTON OTOLOGY NEUROTOLOGY GROUP,  P.S",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-08-29",
        "status": "A",
        "authorized_official_last_name": "STANFILL",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "253-223-0515"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD000010422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507409",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Washington Dental Corporation, PC
• Washington Dental Service
• Washington Institute for Coagulation
• Washington Institute for Coagulation
• Washington Medical Specialists PC
• Washington Spine and Wellness LLC
• Washington Therapy Group, Inc.
• Washington Vaccine Association
• Blair Beverly Washington, MD
• Clint Washington

• Specialist in Seattle, WA
• Providers in Seattle, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2008; 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.