NPIMap

Organization Active NPI

Sammamish Diabetes and Lipid Clinic, PLLC

  • Clinic/Center
  • Sammamish, WA
National Provider Identifier
1578743290
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SAMMAMISH DIABETES AND LIPID CLINIC, PLLC
Practice address
3854 E Lake Sammamish Pkwy NE
Sammamish, WA 98074-4534
Phone
(425) 996-7047
Fax
(425) 996-7087
NPI assigned
Nov 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Authorized official

Name
Dr. Donald Thomas Stewart, MONPI 1659455368
Title
Owner
Phone
(425) 996-7047

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X WA Primary

Addresses

Primary practice location

3854 E Lake Sammamish Pkwy NE
Sammamish, WA 98074-4534

Mailing address

3854 E Lake Sammamish Pkwy NE
Sammamish, WA 98074-4534
Phone (425) 996-7047

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1578743290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3854 E LAKE SAMMAMISH PKWY NE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980744534",
            "telephone_number": "425-996-7047",
            "fax_number": "425-996-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3854 E LAKE SAMMAMISH PKWY NE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980744534",
            "telephone_number": "425-996-7047",
            "fax_number": "425-996-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMMAMISH DIABETES AND LIPID CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-996-7047",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MO"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sammamish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.