Madrona Medical Group, P.S.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

601644971 Issued in WA

Legal business name

MADRONA MEDICAL GROUP, P.S.

Practice address

4545 Cordata Pkwy
Bellingham, WA 98226-7123

Phone

(360) 738-2200

Fax

(360) 753-5673

NPI assigned

Nov 2, 2005

Organization subpart

No

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

Authorized official

Name

Sandy Mellott

Title

Director Clinical Services

Phone

(360) 738-2200

Specialties & licenses 1

Addresses

Other names 1

• Madrona Endoscopy Suite Doing business as

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1659362143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267123",
            "telephone_number": "360-738-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267123",
            "telephone_number": "360-738-2200",
            "fax_number": "360-753-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRONA MEDICAL GROUP, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "MELLOTT",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "DIRECTOR CLINICAL SERVICES",
        "authorized_official_telephone_number": "360-738-2200"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "601644971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madrona Endoscopy Suite",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Griffen Macleod
• Mark Macomber, L.AC.
• Pam Madison, MA
• Madrona Medical Group P.S. DME
• Madrona Medical Group, P.S.
• Madrona Medical Group, PS
• Madrona Medical Group,PS
• Kerry Madrone, MA, LMHC
• Douglas L Madsen, MD
• Gil Caruso Luciano Magadia

• Ambulatory Surgical Clinic/Center in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Ambulatory Surgical Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; 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.