Individual provider Active NPI

Laine Marie Gawthrop, MD

  • Internal Medicine Physician
  • Kirkland, WA
National Provider Identifier
1346339751
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60074830 Issued in WA
Practice address
12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2954
Phone
(425) 814-5000
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL27160 SC
Internal Medicine Physician 207R00000X MD60074830 WA Primary

Addresses

Primary practice location

12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2954

Mailing address

12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2954
Phone (425) 814-5000

Other identifiers 1

IdentifierTypeStateIssuer
8554024MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lgawthrop1042803@wm.providencedirect.org Direct

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
I20090925000158 WA Practitioner - Internal MedicinePractitioner - Psychiatry 3072669480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
West Virginia University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

10416 5TH Ave NE
Seattle, WA 98125-7402
Phone (206) 517-6700

1101 Madison St
Suite 301
Seattle, WA 98104-3599
Phone (206) 505-1300

12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2901
Phone (425) 814-5000

1909 214TH St SE
Suite 300
Bothell, WA 98021-4418
Phone (425) 412-7200

220 15TH Ave SE
Puyallup, WA 98372-3797
Phone (253) 435-3400

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
  • Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051
  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Evergreenhealth Monroe Hospital, Monroe, WA, CCN 500084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL27160SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics Internal Medicine CurrentSince Jul 13, 2012 Accepting new patients
Pacmed Clinics CurrentSince Jul 13, 2012 Accepting new patients

Locations

12910 Totem Lake Blvd NE
Ste 101
Kirkland, WA 98034
Phone (425) 814-5000

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

Interoperability endpoints

  • Direct secure messaging: lgawthrop1042803@wm.providencedirect.org

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1346339751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 TOTEM LAKE BLVD NE",
            "address_2": "SUITE 101",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342954",
            "telephone_number": "425-814-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12910 TOTEM LAKE BLVD NE",
            "address_2": "SUITE 101",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342954",
            "telephone_number": "425-814-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWTHROP",
        "first_name": "LAINE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL27160",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60074830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8554024",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgawthrop1042803@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12910 Totem Lake Blvd NE",
            "address_2": "Suite 101",
            "city": "Kirkland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980342954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.