Adult & Child Medicine LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD00042748 Issued in WA

Legal business name

ADULT & CHILD MEDICINE LLC

Practice address

1207 N 200TH St
Suite # 102
Shoreline, WA 98133-3213

Phone

(206) 533-1570

NPI assigned

Oct 26, 2007

Last updated

Oct 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Irina D Milman, MDNPI 1295736981

Title

Owner

Phone

(206) 533-1570

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

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.

• Irina D Milman, MD

  • Internal Medicine Physician
  • Everett, WA
  • NPI 1295736981
  Medicare reassignment NPD Authorized official
• Alexander V Koryachek, LMT

  • Massage Therapist
  • Shoreline, WA
  • NPI 1124165329
  NPD (past)

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1467631424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 N 200TH ST",
            "address_2": "SUITE # 102",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333213",
            "telephone_number": "206-533-1570",
            "fax_number": "206-533-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 N 200TH ST",
            "address_2": "SUITE # 102",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333213",
            "telephone_number": "206-533-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT & CHILD MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "MILMAN",
        "authorized_official_first_name": "IRINA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-533-1570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "MD00042748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Shoreline, WA
• Providers in Shoreline, 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 Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.