Edmonds Health Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60039274 Issued in WA

Legal business name

EDMONDS HEALTH CLINIC

Practice address

617 5TH Ave S
Edmonds, WA 98020-3452

Phone

(425) 697-2100

Fax

(425) 697-5556

NPI assigned

Sep 27, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Ella Yepraksia Bostanjian, MDNPI 1871735647

Title

Owner

Phone

(425) 697-2100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15297/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ella Yepraksia Bostanjian, M.D.

  • General Practice Physician
  • Edmonds, WA
  • NPI 1871735647
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1649553538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 5TH AVE S",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203452",
            "telephone_number": "425-697-2100",
            "fax_number": "425-697-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 5TH AVE S",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980203452",
            "telephone_number": "425-697-2100",
            "fax_number": "425-697-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMONDS HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-27",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "BOSTANJIAN",
        "authorized_official_first_name": "ELLA",
        "authorized_official_middle_name": "YEPRAKSIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-697-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60039274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmonds Eye M.D., PLLC
• Edmonds Eyecare Associates Inc PS
• Edmonds Family Chiropractic LLC
• Edmonds Family Medicine Clinic PS
• Edmonds Garden Afh LLC
• Edmonds Medical Clinic Inc
• Edmonds Oral & Facial Surgery
• Edmonds Oral Surgery, P.S.
• Edmonds Physical Therapy & Sports Rehab
• Edmonds Psychological and Pastoral Care

• Family Medicine Physician in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.