NPIMap

Organization Active NPI

Leavenworth Family Medicine

  • Family Medicine Physician
  • Peshastin, WA
National Provider Identifier
1881248946
Registry record updated Jul 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LEAVENWORTH FAMILY MEDICINE
Practice address
10090 Main St Apt H
Peshastin, WA 98847-9770
Phone
(509) 881-0722
Fax
(833) 450-1534
NPI assigned
Jul 27, 2019
Last updated
Jul 27, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2019

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

Authorized official

Name
Dr. Jessica Bridges, NDNPI 1720416001
Title
Business Administrator/Physician
Phone
(509) 881-0722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

10090 Main St Apt H
Peshastin, WA 98847-9770

Mailing address

10090 Main St Apt H
Peshastin, WA 98847-9770
Phone (509) 881-0722

National Provider Directory

National Provider Directory

Locations

10090 Main St
Apt H
Peshastin, WA 98847
Phone (509) 676-6009

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1564185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564185600000",
    "number": "1881248946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10090 MAIN ST APT H",
            "city": "PESHASTIN",
            "state": "WA",
            "postal_code": "988479770",
            "telephone_number": "509-881-0722",
            "fax_number": "833-450-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10090 MAIN ST APT H",
            "city": "PESHASTIN",
            "state": "WA",
            "postal_code": "988479770",
            "telephone_number": "509-881-0722",
            "fax_number": "833-450-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAVENWORTH FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-27",
        "last_updated": "2019-07-27",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR/PHYSICIAN",
        "authorized_official_telephone_number": "509-881-0722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ND"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peshastin, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2019; 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.