NPIMap

Organization Active NPI

Eastside Womens Clinic

  • Medical Specialty Clinic/Center
  • Kirkland, WA
National Provider Identifier
1669553251
Registry record updated Oct 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
AP 30000483 Issued in WA
Legal business name
EASTSIDE WOMENS CLINIC
Practice address
11919 NE 128TH St
Suite C
Kirkland, WA 98034-7204
Phone
(425) 899-5600
Fax
(425) 899-5603
NPI assigned
Oct 18, 2006
Last updated
Oct 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2013

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

Authorized official

Name
Suzan Jeanne Watanabe, ARNPNPI 1598845018
Title
Owner
Phone
(425) 899-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 601368747 WA
Medical Specialty Clinic/Center 261QM2500X AP 30000483 WA Primary
Primary Care Clinic/Center 261QP2300X AP 30000483 WA

Addresses

Primary practice location

11919 NE 128TH St
Suite C
Kirkland, WA 98034-7204

Mailing address

11919 NE 128TH St
Suite C
Kirkland, WA 98034-7204
Phone (425) 899-5600

Other identifiers 2

IdentifierTypeStateIssuer
9606690MedicaidWA
WA3359OtherWAREGENCE

Other names 1

  • Suzan Watanabe ARNP Other name

National Provider Directory

National Provider Directory

Locations

11919 NE 128th St
Ste C
Kirkland, WA 98034
Phone (425) 899-5600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1669553251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 NE 128TH ST",
            "address_2": "SUITE C",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347204",
            "telephone_number": "425-899-5600",
            "fax_number": "425-899-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 NE 128TH ST",
            "address_2": "SUITE C",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347204",
            "telephone_number": "425-899-5600",
            "fax_number": "425-899-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE WOMENS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "WATANABE",
        "authorized_official_first_name": "SUZAN",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-899-5600",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "WA",
            "license": "601368747",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "AP 30000483",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "AP 30000483",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9606690",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "WA3359",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suzan Watanabe ARNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.