NPIMap

Organization Active NPI

Pan Pacific Health PPLC

  • Psychiatry Physician
  • Bothell, WA
National Provider Identifier
1669938536
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PAN PACIFIC HEALTH PPLC
Practice address
10634 E Riverside Dr
Bothell, WA 98011-3757
Phone
(206) 484-7701
NPI assigned
Feb 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Authorized official

Name
Liisa Elina Durchman, MDNPI 1891802146
Title
Executive Director
Phone
(206) 484-7701

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
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

10634 E Riverside Dr
Bothell, WA 98011-3757

Mailing address

509 3Rd St
Mukilteo, WA 98275-1551
Phone (206) 484-7701

Other names 1

  • Pan Pacific Health Doing business as

National Provider Directory

National Provider Directory

Locations

10634 E Riverside Dr
Bothell, WA 98011
Phone (206) 484-7701

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1669938536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 3RD ST",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982751551",
            "telephone_number": "206-484-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10634 E RIVERSIDE DR",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980113757",
            "telephone_number": "206-484-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAN PACIFIC HEALTH PPLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-15",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "DURCHMAN",
        "authorized_official_first_name": "LIISA",
        "authorized_official_middle_name": "ELINA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "206-484-7701",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pan Pacific Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.