NPIMap

Organization Active NPI

Premise Health of Washington Medical, P.C

  • General Practice Physician
  • Kirkland, WA
National Provider Identifier
1528345550
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PREMISE HEALTH OF WASHINGTON MEDICAL, P.C
Practice address
747 6TH St S
Kirkland, WA 98033-6715
Phone
(650) 214-6369
NPI assigned
Nov 4, 2011
Organization subpart
Yes
Parent organization
CHS HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Authorized official

Name
Jon Leizman
Title
President
Phone
(216) 479-9063

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

747 6TH St S
Kirkland, WA 98033-6715

Mailing address

5500 Maryland Way
Suite 400
Brentwood, TN 37027-4948

Other names 1

  • Google Wellness Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Google Wellness Center9 organizations share this tax ID, including this one
Part of
Google Wellness Center 321

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660521600000",
    "number": "1528345550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "address_2": "SUITE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 6TH ST S",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336715",
            "telephone_number": "650-214-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF WASHINGTON MEDICAL, P.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHS HEALTH SERVICES",
        "enumeration_date": "2011-11-04",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Google Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Google Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.