Individual provider Active NPI

Alix Champin Thorson, M.D.

  • Emergency Medicine Physician
  • Lynnwood, WA
National Provider Identifier
1295840890
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00039486 Issued in WA
Practice address
4320 196TH St SW
Lynnwood, WA 98036-6773
Phone
(425) 774-8758
Fax
(425) 672-8944
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00039486 WA Primary

Addresses

Primary practice location

4320 196TH St SW
Lynnwood, WA 98036-6773

Mailing address

2930 Maple St
Everett Med Ctr
Everett, WA 98201-3832
Phone (425) 261-1509

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050527000321 WA Practitioner - Emergency Medicine 1355383555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00039486WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 27, 2015 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 27, 2015 Accepting new patients
U.S. Healthworks Medical Group of Washington, PS Past Accepting new patients
North Sound Emergency Medicine PC Emergency Medicine PastSince Feb 8, 2023 Accepting new patients

Locations

2930 Maple St
Everett, WA 98201
Phone (425) 261-1500

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: athorson156572@ghc.direct-ci.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1295840890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 MAPLE ST",
            "address_2": "EVERETT MED CTR",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013832",
            "telephone_number": "425-261-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 196TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366773",
            "telephone_number": "425-774-8758",
            "fax_number": "425-672-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORSON",
        "first_name": "ALIX",
        "middle_name": "CHAMPIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00039486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.