Tammy R. Ellingsen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00031011 Issued in WA

Practice address

546 N Jefferson LN Ste 200
Spokane, WA 99201-7104

Phone

(509) 625-3700

Fax

(509) 625-3747

NPI assigned

Nov 9, 2006

Last updated

Mar 31, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1124264577

  Family Medicine

  NPD
• Kaiser Foundation Health Plan of Washington

  dba Everett Medical Center

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• Providence Health & Services Washington

  dba Providence Medical Group

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1194099390

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1275603094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 N JEFFERSON LN STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992017104",
            "telephone_number": "509-625-3700",
            "fax_number": "509-625-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 N JEFFERSON LN STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992017104",
            "telephone_number": "509-625-3700",
            "fax_number": "509-625-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSEN",
        "first_name": "TAMMY",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00031011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "546 N Jefferson Ln Ste 200",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992017104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blake Ellert, MS
• Ellingsen Henneberg PLLC (Smile Source Spokane)
• Ellingsen Henneberg PLLC (Smile Source North)
• Donald E Ellingsen, M.D.
• Ronald H. Ellingsen, D.D.S.,M.S.D.
• Riann Ellingwood, MS
• Jordan Ellinwood
• Rossi Virginia Heidrich Elliott-Airy, APRN
• Brent Lee Elliott, PHARM D
• Emily Grace Elliott

• Family Medicine Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.