Eastside Family Medicine Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EASTSIDE FAMILY MEDICINE CLINIC

Practice address

1200 112TH Ave NE
Ste C160
Bellevue, WA 98004-3732

Phone

(425) 453-1039

Fax

(425) 453-8955

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Maria G Hebert

Title

Office Manager

Phone

(425) 453-1039

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1548373368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 112TH AVE NE",
            "address_2": "STE C160",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043732",
            "telephone_number": "425-453-1039",
            "fax_number": "425-453-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 112TH AVE NE",
            "address_2": "STE C160",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043732",
            "telephone_number": "425-453-1039",
            "fax_number": "425-453-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE FAMILY MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-453-1039",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7006240",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastside Behavioral Medicine
• Eastside Birth Center, PS
• Eastside Chiropractic Group a Professional Service Corporation
• Eastside Dermatology Inc PS
• Eastside Endocrinology and Diabetes, PS
• Eastside Fertility Lab Inc
• Eastside Integrative Health
• Eastside Internal Medicine & Cardiology David B Ferrin MD
• Eastside Massage Clinic, Inc.
• Eastside Oasis Day Spa & Massage Therapy LLC

• Family Medicine Physician in Bellevue, WA
• Providers in Bellevue, 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 12, 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.