NPIMap

Organization Active NPI

Western Washington Medical Group, Inc PS

  • Clinical Medical Laboratory
  • Everett, WA
National Provider Identifier
1629024740
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
WESTERN WASHINGTON MEDICAL GROUP, INC PS
Practice address
4301 Hoyt Ave
Suite B
Everett, WA 98203-2316
Phone
(425) 257-9997
NPI assigned
May 26, 2006
Organization subpart
Yes
Parent organization
WESTERN WASHINGTON MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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

Authorized official

Name
Vicki M McGinnis
Title
Privacy Officer
Phone
(425) 259-4041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

4301 Hoyt Ave
Suite B
Everett, WA 98203-2316

Mailing address

1728 W Marine View Dr
Suite 111
Everett, WA 98201-2094
Phone (425) 740-4177

Other identifiers 3

IdentifierTypeStateIssuer
P00162700OtherRR MEDICARE
0188172OtherWALABOR AND INDUSTRY
7124795MedicaidWA

Other names 1

  • Western Washington Medical Group Department of Laboratory Services Doing business as

National Provider Directory

National Provider Directory
Part of
Western Washington Med GRP

Locations

4301 Hoyt Ave
Ste B
Everett, WA 98203
Phone (425) 257-9997

1728 W Marine View Dr
Everett, WA 98201
Phone (425) 252-9216

1728 W Marine View Dr
Ste 111
Everett, WA 98201

4301 Hoyt Ave
#M
Everett, WA 98203
Phone (425) 247-9997

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1629024740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 W MARINE VIEW DR",
            "address_2": "SUITE 111",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012094",
            "telephone_number": "425-740-4177",
            "fax_number": "425-252-6642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 HOYT AVE",
            "address_2": "SUITE B",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982032316",
            "telephone_number": "425-257-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN WASHINGTON MEDICAL GROUP, INC PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN WASHINGTON MEDICAL GROUP",
        "enumeration_date": "2006-05-26",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "MCGINNIS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRIVACY OFFICER",
        "authorized_official_telephone_number": "425-259-4041"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00162700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRY",
            "identifier": "0188172",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7124795",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Washington Medical Group Department of Laboratory Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; 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.