Puget Sound Gastroenterology, PLLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

PUGET SOUND GASTROENTEROLOGY, PLLC

Practice address

21600 Highway 99 Ste 260
Edmonds, WA 98026-8049

Phone

(425) 774-2650

Fax

(425) 774-2643

NPI assigned

Jul 3, 2023

Last updated

May 16, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

PUGET SOUND GASTROENTEROLOGY, PLLCAs reported in NPPES

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

Authorized official

Name

Alan Oliver, CEO

Title

Ceo

Phone

(786) 530-3820

Specialties & licenses 1

Addresses

Other names 1

• Washington Pharmacy Other name

Tax ID family

Sea Gastroenterology As4 organizations share this tax ID, including this one

Part of

Sea Gastroenterology As

Other organizations with this tax ID 3

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

• Puget Sound Gastroenterology, PLLC

  • Non-Pharmacy Dispensing Site
  • Kirkland, WA
  • NPI 1801576368
  NPD tax ID
• Puget Sound Gastroenterology, PLLC

  • Gastroenterology Physician
  • Mill Creek, WA
  • NPI 1912929738
  NPD tax ID
• Puget Sound Gastroenterology, PLLC

  dba Tri-Cities Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Kennewick, WA
  • NPI 1952068298
  NPD tax ID

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1366129132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 S DADELAND BLVD STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331562866",
            "telephone_number": "786-530-3820",
            "fax_number": "305-675-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21600 HIGHWAY 99 STE 260",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268049",
            "telephone_number": "425-774-2650",
            "fax_number": "425-774-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND GASTROENTEROLOGY, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUGET SOUND GASTROENTEROLOGY, PLLC",
        "enumeration_date": "2023-07-03",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-530-3820",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Washington Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Public Hospital District 2 of Snohomish County (Stevens Pain Treatment Center)
• Public Hospital District 2 of Snohomish County (Birth & Family Clinic)
• Puget Sound Dermatology, PLLC
• Puget Sound Family Physicians
• Puget Sound Gastroenterology, PLLC (Puget Sound Gastroenterology at Edmonds)
• Puget Sound Gastroenterology, PLLC (Edmonds Endoscopy Center)
• Puget Sound Medical Associates LLC
• Puget Sound Neurology
• Puget Sound Otolaryngology Inc PS (Puget Sound Surgicenter)
• Chetan Pungoti, MD

• Gastroenterology Physician in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Gastroenterology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.