Madrona Medical Group, P.S.

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

MADRONA MEDICAL GROUP, P.S.

Practice address

4545 Cordata Pkwy
Bellingham, WA 98226-7123

Phone

(360) 738-2200

NPI assigned

Nov 4, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandy Mellott

Title

Director Clinical Services

Phone

(360) 738-2200

Specialties & licenses 1

Addresses

Other names 1

• Madrona Sleep Center Other name

Tax ID family

Madrona Medical Group PS DME2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Madrona Medical Group P.S. DME

  • Durable Medical Equipment & Medical Supplies
  • Bellingham, WA
  • NPI 1275734691
  NPD tax ID

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598756777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267123",
            "telephone_number": "360-738-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267123",
            "telephone_number": "360-738-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRONA MEDICAL GROUP, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MELLOTT",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "DIRECTOR CLINICAL SERVICES",
        "authorized_official_telephone_number": "360-738-2200"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madrona Sleep Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kayla Maclain
• Griffen Macleod
• Mark Macomber, L.AC.
• Pam Madison, MA
• Madrona Medical Group P.S. DME
• Madrona Medical Group, P.S. (Madrona Endoscopy Suite)
• Madrona Medical Group, PS
• Madrona Medical Group,PS
• Kerry Madrone, MA, LMHC
• Douglas L Madsen, MD

• Sleep Disorder Diagnostic Clinic/Center in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Sleep Disorder Diagnostic Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.