Individual provider Active NPI

Michele Yi, MD

  • Pediatrics Physician
  • Bonney Lake, WA
National Provider Identifier
1619169638
Registry record updated Apr 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60078044 Issued in WA
Practice address
10004 204TH Ave E
Suite 1300
Bonney Lake, WA 98391
Phone
(253) 848-8797
Fax
(253) 845-0100
NPI assigned
Aug 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60078044 WA Primary

Addresses

Primary practice location

10004 204TH Ave E
Suite 1300
Bonney Lake, WA 98391

Mailing address

11102 Sunrise Blvd E
Suite 103
Puyallup, WA 98374
Phone (253) 848-8797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180412000260 WA Practitioner - Pediatric Medicine 2365705910 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60078044WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 5, 2018 Accepting new patients
Multicare Health System CurrentSince Mar 5, 2018 Accepting new patients
Multicare Health System Current Accepting new patients

Locations

10004 204th Ave E
Ste 1300
Bonney Lake, WA 98391
Phone (253) 848-8797

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

11102 Sunrise Blvd E
Ste 103
Puyallup, WA 98374
Phone (253) 848-8797

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428624000000",
    "number": "1619169638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11102 SUNRISE BLVD E",
            "address_2": "SUITE 103",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98374",
            "telephone_number": "253-848-8797",
            "fax_number": "253-845-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 204TH AVE E",
            "address_2": "SUITE 1300",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "98391",
            "telephone_number": "253-848-8797",
            "fax_number": "253-845-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "MICHELE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2015-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "60078044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

Verify at the official NPI Registry.