Active NPI
Camelia G Whitten, MD
- Diagnostic Radiology Physician
- Lynnwood, WA
National Provider Identifier
1639179096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD00046751
- Practice address
- 19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748 - Phone
- (425) 563-1500
- Fax
- (425) 563-1501
- NPI assigned
- Jul 28, 2005
- Last updated
- Apr 30, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD00046751 | WA | Primary |
Addresses
Primary practice location
19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Mailing address
19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Phone (425) 563-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1015169 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556582400000",
"number": "1639179096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19020 33RD AVE W STE 210",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364748",
"telephone_number": "425-563-1500",
"fax_number": "425-563-1374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19020 33RD AVE W STE 210",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364748",
"telephone_number": "425-563-1500",
"fax_number": "425-563-1501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITTEN",
"first_name": "CAMELIA",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-28",
"last_updated": "2019-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "WA",
"license": "MD00046751",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1015169",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.