NPIMap

Organization Active NPI

Poma Fertility Medical Associates, PLLC

  • Medical Specialty Clinic/Center
  • Kirkland, WA
National Provider Identifier
1669717278
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
MD00004391
Legal business name
POMA FERTILITY MEDICAL ASSOCIATES, PLLC
Practice address
12039 NE 128TH St Ste 110
Kirkland, WA 98034-3030
Phone
(425) 822-7662
Fax
(425) 822-0172
NPI assigned
Dec 7, 2012
Last updated
Dec 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Authorized official

Name
Dr. Michael S Opsahl, M.D.NPI 1710056239
Title
Manager
Phone
(425) 822-7662

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X MD00004391 Primary

Addresses

Primary practice location

12039 NE 128TH St Ste 110
Kirkland, WA 98034-3030

Mailing address

12039 NE 128TH St Ste 110
Kirkland, WA 98034-3030
Phone (425) 822-7662

National Provider Directory

National Provider Directory

Locations

12039 NE 128th St
Ste 11O
Kirkland, WA 98034

Practitioners & affiliated clinicians

Practitioners 9

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": "1354838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1669717278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 110",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343030",
            "telephone_number": "425-822-7662",
            "fax_number": "425-822-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 110",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343030",
            "telephone_number": "425-822-7662",
            "fax_number": "425-822-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POMA FERTILITY MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-07",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "OPSAHL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "425-822-7662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": "MD00004391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 7, 2012; 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.