NPIMap

Organization Active NPI

Issaquah Medical Group

  • Pediatrics Physician
  • Issaquah, WA
National Provider Identifier
1649316266
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00043371 Issued in WA
Legal business name
ISSAQUAH MEDICAL GROUP
Practice address
450 NW Gilman Blvd Ste 201
Issaquah, WA 98027-2483
Phone
(425) 391-0705
Fax
(425) 391-9562
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Michael P Hourigan
Title
Administrator
Phone
(425) 391-0705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X MD00043371 WA Primary

Addresses

Primary practice location

450 NW Gilman Blvd Ste 201
Issaquah, WA 98027-2483

Mailing address

450 NW Gilman Blvd Ste 201
Issaquah, WA 98027-2483
Phone (425) 391-0705

National Provider Directory

National Provider Directory
Tax ID family
Issaquah Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1649316266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 NW GILMAN BLVD STE 201",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272483",
            "telephone_number": "425-391-0705",
            "fax_number": "425-391-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NW GILMAN BLVD STE 201",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272483",
            "telephone_number": "425-391-0705",
            "fax_number": "425-391-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISSAQUAH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "HOURIGAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "425-391-0705",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00043371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.