Organization Active NPI

Wound Pros Washington

  • General Practice Physician
  • Kirkland, WA
National Provider Identifier
1376158725
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
WOUND PROS WASHINGTON
Practice address
11335 NE 122ND
Suite 105
Kirkland, WA 98034-6933
Phone
(310) 496-5844
Fax
(323) 433-9177
NPI assigned
Sep 12, 2020
Last updated
Feb 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Authorized official

Name
Dr. Christopher Ayodele Otiko, DPMNPI 1346223997
Title
President
Phone
(818) 836-2475

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

11335 NE 122ND
Suite 105
Kirkland, WA 98034-6933

Mailing address

5901 W Century Blvd Ste 750
Los Angeles, CA 90045-5443
Phone (323) 480-4075

National Provider Directory

National Provider Directory

Locations

4640 Admiralty Way
Ste 500
Marina del Rey, CA 90292
Phone (323) 434-9441

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1599868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1376158725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 W CENTURY BLVD STE 750",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455443",
            "telephone_number": "323-480-4075",
            "fax_number": "323-433-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11335 NE 122ND",
            "address_2": "SUITE 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346933",
            "telephone_number": "310-496-5844",
            "fax_number": "323-433-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND PROS WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-12",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "OTIKO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "AYODELE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-836-2475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.