NPIMap

Organization Active NPI

Northwest Asthma & Allergy Center

  • Allergy & Immunology Physician
  • Redmond, WA
National Provider Identifier
1760620462
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
600 176 916 Issued in WA
Legal business name
NORTHWEST ASTHMA & ALLERGY CENTER
Practice address
22635 NE Marketplace Dr
Suite 110
Redmond, WA 98053-5885
Phone
(206) 527-2577
Fax
(206) 527-2514
NPI assigned
Feb 3, 2009
Organization subpart
Yes
Parent organization
NORHTWEST ASTHMA & ALLERGY CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Authorized official

Name
Patricia S. Mathias
Title
Credentialing Coordinator
Phone
(206) 527-2577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207K00000X 600 176 916 WA Primary

Addresses

Primary practice location

22635 NE Marketplace Dr
Suite 110
Redmond, WA 98053-5885

Mailing address

4540 Sand Point Way NE
Suite 200
Seattle, WA 98105-3941
Phone (206) 527-2577

Other identifiers 1

IdentifierTypeStateIssuer
CP7653OtherWARAIL ROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000462 WA Part B Supplier - Clinic/Group Practice 6507759743 Receives reassigned benefits from 20 practitioners
8 other NPIs on this enrollment
Practice locations: Everett, WA; Issaquah, WA; Pasco, WA; Redmond, WA; Renton, WA; Seattle, WA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Northwest Asthma Allergy C

Locations

22635 NE Marketplace Dr
Ste 110
Redmond, WA 98053
Phone (206) 527-2577

9725 3rd Ave NE
Ste 500
Seattle, WA 98115
Phone (206) 527-1200

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1760620462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 SAND POINT WAY NE",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053941",
            "telephone_number": "206-527-2577",
            "fax_number": "206-527-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22635 NE MARKETPLACE DR",
            "address_2": "SUITE 110",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980535885",
            "telephone_number": "206-527-2577",
            "fax_number": "206-527-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST ASTHMA & ALLERGY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORHTWEST ASTHMA & ALLERGY CENTER",
        "enumeration_date": "2009-02-03",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "MATHIAS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "206-527-2577"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "WA",
            "license": "600 176 916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CP7653",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.