Organization Active NPI

Family and Wellness Medicine

  • Primary Care Clinic/Center
  • Federal Way, WA
National Provider Identifier
1679042501
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
FAMILY AND WELLNESS MEDICINE
Practice address
34004 16TH Ave S Ste 100
Federal Way, WA 98003-8905
Phone
(206) 487-4007
NPI assigned
Nov 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Authorized official

Name
Dr. Savio Pham
Title
Ceo
Phone
(206) 487-4007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

34004 16TH Ave S Ste 100
Federal Way, WA 98003-8905

Mailing address

5140 S 166TH LN
Seatac, WA 98188-3284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220823001564 WA Part B Supplier - Clinic/Group Practice 0042693129 Receives reassigned benefits from 1 practitioner
Practice locations: Federal Way, WA

National Provider Directory

National Provider Directory

Locations

34004 16th Ave S
Ste 100
Federal Way, WA 98003
Phone (206) 487-4007

Practitioners & affiliated clinicians

Practitioners 1

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": "1542672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542672000000",
    "number": "1679042501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5140 S 166TH LN",
            "city": "SEATAC",
            "state": "WA",
            "postal_code": "981883284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34004 16TH AVE S STE 100",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038905",
            "telephone_number": "206-487-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY AND WELLNESS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "SAVIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-487-4007",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; 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.