NPIMap

Organization Active NPI

Plateau Emergency Physicians

  • Emergency Medicine Physician
  • Enumclaw, WA
National Provider Identifier
1497785315
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PLATEAU EMERGENCY PHYSICIANS
Practice address
1450 Battersby Ave
Emergency Department
Enumclaw, WA 98022-3634
Phone
(360) 825-2505
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Charles T. Mitchell, MD
Title
President
Phone
(800) 444-7009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1450 Battersby Ave
Emergency Department
Enumclaw, WA 98022-3634

Mailing address

PO Box 7720
Philadelphia, PA 19101-7720
Phone (800) 444-7009

Other identifiers 1

IdentifierTypeStateIssuer
7127384MedicaidWA

National Provider Directory

National Provider Directory

Locations

1450 Battersby Ave
Emergency Dept
Enumclaw, WA 98022
Phone (360) 825-2505

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1497785315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7720",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191017720",
            "telephone_number": "800-444-7009",
            "fax_number": "800-305-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 BATTERSBY AVE",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980223634",
            "telephone_number": "360-825-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATEAU EMERGENCY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-444-7009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7127384",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enumclaw, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.