Canyon Creek Clinic, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

CANYON CREEK CLINIC, PLLC

Practice address

19125 N Creek Pkwy
Suite 204
Bothell, WA 98011-8035

Phone

(425) 424-2201

Fax

(425) 398-4172

NPI assigned

May 30, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Cathy G Knoth

Title

Office Manager

Phone

(425) 424-2201

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pamela J Hermes, PA-C

  • Medical Physician Assistant
  • Duluth, MN
  • NPI 1568776409
  NPD (past)
• Ron L. Hood, MD

  • Emergency Medicine Physician
  • Sonora, CA
  • NPI 1730292483
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1447451216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19125 N CREEK PKWY",
            "address_2": "SUITE 204",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118035",
            "telephone_number": "425-424-2201",
            "fax_number": "425-398-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19125 N CREEK PKWY",
            "address_2": "SUITE 204",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980118035",
            "telephone_number": "425-424-2201",
            "fax_number": "425-398-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANYON CREEK CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KNOTH",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-424-2201",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Songrui Cai, RD
• Carlos E Caldera
• Brittney Campbell, RN
• Tonja M Campbell, BSN, RN, CCM, WWCP
• Daniella Rose Cannone, DPT
• Jing Cao
• Feby Bianca Caoile, OTR/L
• Capstone Health Services Inc. (Capstone Physical Therapy)
• Jeanne Carbonetti, LMHC
• Caremark, L.L.C. (Caremark Washington Specialty Pharmacy, LLC)

• Primary Care Clinic/Center in Bothell, WA
• Providers in Bothell, WA by specialty
• Primary Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.