Public Hospital District #1 of King County

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

PUBLIC HOSPITAL DISTRICT #1 OF KING COUNTY

Practice address

24920 104TH Ave SE
Kent, WA 98030-6443

Phone

(253) 395-2000

Fax

(253) 395-1956

NPI assigned

May 28, 2006

Organization subpart

No

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

Authorized official

Name

Melissa Farley, CPC

Title

Technical Coordinator

Phone

(425) 917-6282

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• VMC Kent Primary Care Doing business as

Locations

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1376590026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980554934",
            "telephone_number": "425-656-5412",
            "fax_number": "425-656-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24920 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980306443",
            "telephone_number": "253-395-2000",
            "fax_number": "253-395-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DISTRICT #1 OF KING COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "TECHNICAL COORDINATOR",
        "authorized_official_telephone_number": "425-917-6282",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7060353",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VMC Kent Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chandra Delaine Pugh

• Adult Medicine Physician in Kent, WA
• Providers in Kent, WA by specialty
• Adult Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.