Eastside Medicine PS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00026250 Issued in WA

Legal business name

EASTSIDE MEDICINE PS

Practice address

18920 Bothell Way NE
Suite 203
Bothell, WA 98011-1981

Phone

(425) 318-4848

Fax

(786) 975-2643

NPI assigned

Dec 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Harry Pepe III, MD

Title

Owner

Phone

(425) 318-4848

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1679757405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18920 BOTHELL WAY NE",
            "address_2": "SUITE 203",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980111981",
            "telephone_number": "425-318-4848",
            "fax_number": "786-975-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18920 BOTHELL WAY NE",
            "address_2": "SUITE 203",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980111981",
            "telephone_number": "425-318-4848",
            "fax_number": "786-975-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE MEDICINE PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "PEPE",
        "authorized_official_first_name": "HARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-318-4848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00026250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8120255",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riley Kathleen Earls
• Manoj John Easaw
• Ishmael Jaumarr Easton, LMP
• Eastside Chiropractic PC
• Eastside Gentle Acupuncture LLC
• Eastside Reading and Language Therapy, LLC
• Eastside Rivers Wellness PLLC
• Megan Anne Ebel, O.D.
• Mona Ebrahimi, LMHC
• Buckley A Eckert, M.D.

• Family Medicine Physician in Bothell, WA
• Providers in Bothell, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.