Organization Active NPI

Northwest Physical Medicine PS

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Bellevue, WA
National Provider Identifier
1265701965
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
MD00044383 Issued in WA
Legal business name
NORTHWEST PHYSICAL MEDICINE PS
Practice address
10655 NE 4TH St
Suite 101
Bellevue, WA 98004-5035
Phone
(425) 455-2225
NPI assigned
Dec 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Authorized official

Name
Dr. Raymon Kooner, MD
Title
Owner
Phone
(425) 455-2225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X MD00044383 WA Primary

Addresses

Primary practice location

10655 NE 4TH St
Suite 101
Bellevue, WA 98004-5035

Mailing address

10655 NE 4TH St
Suite 101
Bellevue, WA 98004-5035
Phone (425) 455-2225

Other names 1

  • Bellevue Wellness Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1324857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338336000000",
    "number": "1265701965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10655 NE 4TH ST",
            "address_2": "SUITE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045035",
            "telephone_number": "425-455-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10655 NE 4TH ST",
            "address_2": "SUITE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045035",
            "telephone_number": "425-455-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PHYSICAL MEDICINE PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-26",
        "last_updated": "2012-05-30",
        "status": "A",
        "authorized_official_last_name": "KOONER",
        "authorized_official_first_name": "RAYMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-455-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WA",
            "license": "MD00044383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellevue Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.