Mission Healthcare at Bellevue, Joint Venture

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MISSION HEALTHCARE AT BELLEVUE, JOINT VENTURE

Practice address

17420 106TH PL SE
Renton, WA 98055-5438

Phone

(425) 362-6200

NPI assigned

Apr 22, 2019

Organization subpart

Yes

Parent organization

MISSION HEALTHCARE AT BELLEVUE, JOINT VENTUREAs reported in NPPES

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

Authorized official

Name

Mondell E Workman

Title

Executive Director

Phone

(425) 362-6200

Specialties & licenses 1

Addresses

Other names 1

• Mission Healthcare at Renton Doing business as

Part of

Mission Healthcare at Bellevue Joint Venture

Locations

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.

• Mission Healthcare at Bellevue, Joint Venture

  • Skilled Nursing Facility
  • Bellevue, WA
  • NPI 1730189440
  NPPES parent name

Practitioners 2

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

• Caleb T Chu, MD

  • Internal Medicine Physician
  • Tacoma, WA
  • NPI 1316668320
  NPD (past)
• Neriza Gomez Mercado, MD

  • General Practice Physician
  • Tacoma, WA
  • NPI 1285314179
  NPD (past)

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555891200000",
    "number": "1487217824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 POINT FOSDICK DR NW STE 203",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351703",
            "telephone_number": "253-853-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17420 106TH PL SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555438",
            "telephone_number": "425-362-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION HEALTHCARE AT BELLEVUE, JOINT VENTURE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSION HEALTHCARE AT BELLEVUE, JOINT VENTURE",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-22",
        "status": "A",
        "authorized_official_last_name": "WORKMAN",
        "authorized_official_first_name": "MONDELL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "425-362-6200"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mission Healthcare at Renton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul Minnich
• Minuteclinic Primary Care Washington PLLC
• Wendy Mironov, ARNP
• Krisha-Tyra Misa, DDS, MS
• Michael Aziz Mishalanie, DPM
• Mission Healthcare at Renton, LLC
• Leanne Mitchell, PT
• Myesha Mitchell
• Taryn Reiko Miyaoka, PA-C
• Hikari Daniel Mizukami, DPT

• Skilled Nursing Facility in Renton, WA
• Providers in Renton, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; 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.