Northwest Asthma & Allergy Center

Organization Active NPI Allergy & Immunology Physician · Renton, WA

NPI 1457565459 · NPPES record last updated Apr 23, 2010

Key facts

NPI
1457565459
Entity type
Organization (NPI type 2)
Primary specialty
Allergy & Immunology Physician 207K00000X
Legal business name
NORTHWEST ASTHMA & ALLERGY CENTER
Practice address
1412 SW 43Rd St
Suite 210
Renton, WA 98055-4803
Phone
(425) 235-1716
Fax
(425) 277-5479
NPI assigned
May 9, 2007
Organization subpart
Yes
Parent organization (as reported)
NORTHWEST ASTHMA & ALLERGY CENTER

Authorized official

Name
Patricia S. Mathias
Title
Credentialing Coordinator
Phone
(206) 527-2577

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 3

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

Practitioners 3

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2011385Northwest Asthma and Allergy Center
1412 SW 43Rd St Ste 210, Renton, WA 98055
Provider-performed microscopyApr 4, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040209000462 WA Part B Supplier - Clinic/Group Practice 6507759743 Receives reassigned benefits from 20 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Everett, WA; Issaquah, WA; Pasco, WA; Redmond, WA; Renton, WA; Seattle, WA

National Provider Directory

Tax ID family
Northwest Asthma Allergy C (4 organizations share this tax ID)
Part of
Northwest Asthma Allergy C

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207K00000X Yes

Addresses

Primary practice location

1412 SW 43Rd St
Suite 210
Renton, WA 98055-4803

Mailing address

4540 Sand Point Way NE
Suite 200
Seattle, WA 98105-3941
Phone (206) 527-1200

Other identifiers

IdentifierTypeStateIssuer
CP7653OtherWARAILROAD MEDICARE

Other providers in Renton, WA

All providers in Renton, WA · Allergy & Immunology Physician in Washington

Sources for this page

Verify at the official NPI Registry.