Individual provider Active NPI

Kathleen Song, DO

  • Obstetrics & Gynecology Physician
  • Kirkland, WA
National Provider Identifier
1851706261
Registry record updated May 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OP60849067 Issued in WA
Practice address
12333 NE 130TH LN Ste Tan 110
Kirkland, WA 98034-7467
Phone
(425) 285-0060
NPI assigned
Jun 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OP60849067 WA Primary

Addresses

Primary practice location

12333 NE 130TH LN Ste Tan 110
Kirkland, WA 98034-7467

Mailing address

12333 NE 130TH LN Ste Tan 110
Kirkland, WA 98034-7467
Phone (425) 285-0060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181009003047 WA Practitioner - Obstetrics/Gynecology 8820214984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Pacific Medical College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1909 214TH St SE
Suite 110
Bothell, WA 98021-4412
Phone (425) 488-4988

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 CurrentSince Oct 1, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Multicare Health System CurrentSince Aug 20, 2018 Accepting new patients
Multicare Health System CurrentSince Aug 20, 2018 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Oct 1, 2023 Accepting new patients
King County Public Hospital District No. 2 Past Accepting new patients
Multicare Health System Past Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

12333 NE 130th Ln
Ste 110
Kirkland, WA 98034
Phone (425) 285-0060

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1851706261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12333 NE 130TH LN STE TAN 110",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347467",
            "telephone_number": "425-285-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12333 NE 130TH LN STE TAN 110",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347467",
            "telephone_number": "425-285-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "KATHLEEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "OP60849067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.