Chester Edmond Jangala, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00023662 Issued in WA

Practice address

22443 SE 240TH St Ste 203
Maple Valley, WA 98038-5879

Phone

(425) 432-9611

Fax

(206) 973-5399

NPI assigned

May 25, 2006

Last updated

Mar 6, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 12, 2017 through Jan 12, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Wilderness Medical Clinic LLC

  dba Chet Jangala, MD

  • Medical Specialty Clinic/Center
  • Maple Valley, WA
  • NPI 1669647152
  NPD (past) Authorized official
• Lake Wilderness Medical Clinic LLC

  • Exclusive Provider Organization
  • Maple Valley, WA
  • NPI 1982879045
  Authorized official Same address or phone
• Pacific Palisades Podiatry PLLC

  • Foot & Ankle Surgery Podiatrist
  • Federal Way, WA
  • NPI 1669428934
  NPD (past)
• Public Hospital District 1 of King County

  dba Prescription Pad Pharmacy South

  • Institutional Pharmacy
  • Renton, WA
  • NPI 1679862189
  NPD (past)
• Public Hospital District No 4 King County Washington

  dba Snoqualmie Valley Hospital

  • Critical Access Hospital
  • Snoqualmie, WA
  • NPI 1902846546
  NPD (past)
• Public Hospital District No 4, King County Wa

  dba Public Hospital District No 4 Clinic

  • Family Medicine Physician
  • Snoqualmie, WA
  • NPI 1144432634
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1538115472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22443 SE 240TH ST STE 203",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385879",
            "telephone_number": "425-432-9611",
            "fax_number": "206-973-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22443 SE 240TH ST STE 203",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980385879",
            "telephone_number": "425-432-9611",
            "fax_number": "206-973-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANGALA",
        "first_name": "CHESTER",
        "middle_name": "EDMOND",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00023662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Kate Hove, LMHC
• Stephanie D Howell, LMP
• Janique Huery
• Amanda Hunsberger, LMHCA
• Unknown Indu Singh
• Josephine Jarvis, MA, OTR-L
• Kenneth L Jasman, PHARMACIST
• Julie A Javonillo, COTA/L
• Susan Jenks, COTA
• Laura Jimenez, ND

• Family Medicine Physician in Maple Valley, WA
• Providers in Maple Valley, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.