NPIMap

Organization Active NPI

Northwest Asthma & Allergy Center

  • Allergy & Immunology Physician
  • Everett, WA
National Provider Identifier
1275608648
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
NORTHWEST ASTHMA & ALLERGY CENTER
Practice address
10333 19TH Ave SE
#105
Everett, WA 98208-4267
Phone
(425) 385-2802
Fax
(425) 337-7967
NPI assigned
Nov 21, 2006
Last updated
Apr 23, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHWEST ASTHMA & ALLERGY CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Authorized official

Name
Patricia S. Mathias
Title
Credentialing Coordinator
Phone
(206) 527-2577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X NU Primary

Addresses

Primary practice location

10333 19TH Ave SE
#105
Everett, WA 98208-4267

Mailing address

4540 Sand Point Way NE
Suite 200
Seattle, WA 98105-3941
Phone (206) 527-1200

Other identifiers 3

IdentifierTypeStateIssuer
CI9081OtherRAILROAD MEDICARE
7701808MedicaidWA
NO4513OtherWAREGENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000462 WA Part B Supplier - Clinic/Group Practice 6507759743 Receives reassigned benefits from 20 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Everett, WA; Issaquah, WA; Pasco, WA; Redmond, WA; Renton, WA; Seattle, WA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0977101Northwest Asthma & Allergy10333 19TH Ave SE Ste 105, Everett, WA 98208Provider-performed microscopyApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
NW Asthma Allergy Center4 organizations share this tax ID, including this one
Part of
NW Asthma Allergy Center

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10333 19th Ave SE
Ste 105
Everett, WA 98208
Phone (425) 385-2802

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1275608648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 SAND POINT WAY NE",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053941",
            "telephone_number": "206-527-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10333 19TH AVE SE",
            "address_2": "#105",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084267",
            "telephone_number": "425-385-2802",
            "fax_number": "425-337-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ASTHMA & ALLERGY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST ASTHMA & ALLERGY CENTER",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "MATHIAS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "206-527-2577"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI9081",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7701808",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "NO4513",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.