Gandis G Mazeika MD PS

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

License

MD00044962 Issued in WA

Legal business name

GANDIS G MAZEIKA MD PS

Doing business as

Sleep Medicine Northwest

Practice address

21701 76TH Ave W Ste 206
Edmonds, WA 98026-7536

Phone

(425) 636-2400

Fax

(425) 636-2401

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Gandis G Mazeika, MD

Title

President

Phone

(425) 636-2400

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Sleep Medicine Northwest Doing business as

Tax ID family

Gandis G Mazeika MD PS2 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.

• Gandis G Mazeika MD PS

  • Sleep Disorder Diagnostic Clinic/Center
  • Edmonds, WA
  • NPI 1568182814
  NPD tax ID

Locations

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1639117393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16150 NE 85TH ST STE 203",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523543",
            "telephone_number": "425-636-2400",
            "fax_number": "425-636-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21701 76TH AVE W STE 206",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267536",
            "telephone_number": "425-636-2400",
            "fax_number": "425-636-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GANDIS G MAZEIKA MD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "MAZEIKA",
        "authorized_official_first_name": "GANDIS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-636-2400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "WA",
            "license": "MD000386959",
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "WA",
            "license": "MD00044962",
            "primary": true
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "WA",
            "license": "RN00103961",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1110972",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MD00038659",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sleep Medicine Northwest",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sleep Medicine Northwest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaitlin Marie Galvagno, OTD, OTR/L
• Jade Wan-Theng Gan, DDS
• Matthew D Gandall
• Gandis G Mazeika MD PS
• Gandis G Mazeika MD PS
• Amanda Ganete, PA-C
• Xiomara Garcia
• Stacy Elizabeth Gardea, CDPT
• Kelsey Nicole Gardetto, PHARMD
• Denise Nicole Gardner, LMP

• Sleep Disorder Diagnostic Clinic/Center in Edmonds, WA
• Providers in Edmonds, 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 Oct 12, 2022; 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.