Willow Bridge LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

WILLOW BRIDGE LLC

Practice address

2311 E Division St
Mount Vernon, WA 98274-4791

Phone

(425) 678-3339

NPI assigned

Apr 20, 2022

Organization subpart

No

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

Authorized official

Name

Momodou Sowe

Title

Manager

Phone

(202) 507-9826

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1760126320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 214",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982750214",
            "telephone_number": "425-760-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 E DIVISION ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744791",
            "telephone_number": "425-678-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW BRIDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A",
        "authorized_official_last_name": "SOWE",
        "authorized_official_first_name": "MOMODOU",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "202-507-9826"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandi Lynn Williams
• Noble Williams
• Sara Elizabeth Williams, RDH
• Richard V. Williamson, MD
• Alexander Willis, M.D.
• Roger Lewis Wills
• Elizabeth J Wilson, OTR-L
• Rebecca Lynne Wilson, LMT
• Susan Wilson, PA-C
• Anne C Winkes, ARNP

• Alzheimer Center (Dementia Center) in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Alzheimer Center (Dementia Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; 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.