NPIMap

Organization Active NPI

King County Public Hospital District No 2

Doing business as EvergreenHealth Medical Group Snohomish County

  • Family Medicine Physician
  • Bothell, WA
National Provider Identifier
1902907165
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Doing business as
EvergreenHealth Medical Group Snohomish County
Practice address
1909 214TH St SE
Suite 110
Bothell, WA 98021-8486
Phone
(425) 488-4988
Fax
(425) 488-4993
NPI assigned
Sep 26, 2006
Last updated
Nov 6, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Authorized official

Name
William Howe
Title
Cfo
Phone
(425) 899-2606

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Physical Medicine & Rehabilitation Physician 208100000X

Addresses

Primary practice location

1909 214TH St SE
Suite 110
Bothell, WA 98021-8486

Mailing address

PO Box 102928
Pasadena, CA 91189-2928
Phone (425) 899-3868

Other identifiers 5

IdentifierTypeStateIssuer
CG8137OtherWAMEDICARE RAILROAD
CQ2437OtherWAMEDICARE RAILROAD
CJ9678OtherWAMEDICARE RAILROAD
CG2833OtherWAMEDICARE RAILROAD
7072358MedicaidWA

Other names 1

  • EvergreenHealth Medical Group Snohomish County Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000557 WA Part B Supplier - Clinic/Group Practice 7618880097 Receives reassigned benefits from 1,160 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kirkland, WA; Mill Creek, WA; Monroe, WA; Redmond, WA; Sammamish, WA; Sultan, WA; Woodinville, WA; Bothell, WA…

Other NPIs on the same Medicare enrollment 27

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

View all 27

National Provider Directory

National Provider Directory
Part of
Evergreen Hosp Medical

Locations (25 of 53)

1035 116th Ave NE
#600
Bellevue, WA 98004

11232 NE 15th St
Ste 200
Bellevue, WA 98004

10025 NE 186th St
#143
Bothell, WA 98011

10025 NE 186th St
Stop 143
Bothell, WA 98011

14720 Main St NE
Ste 87
Duvall, WA 98019

6520 226th Pl SE
Ste 205
Issaquah, WA 98027
Phone (425) 392-8611

11400 98th Ave NE
Ste 200
Kirkland, WA 98033
Phone (360) 220-2585

11521 NE 128th St
#103
Kirkland, WA 98034

11800 NE 128th St
Ste 200
Kirkland, WA 98034
Phone (425) 899-3300

11800 NE 128th St
Ste 530
Kirkland, WA 98034
Phone (425) 454-1111

11911 NE 132nd St
Kirkland, WA 98034
Phone (425) 814-5100

12039 NE 128th St
Ste 200
Kirkland, WA 98034
Phone (425) 899-3139

12039 NE 128th St
Ste 400
Kirkland, WA 98034
Phone (425) 899-4810

12039 NE 128th St
Ste 500
Kirkland, WA 98034
Phone (425) 899-1220

12040 NE 128th St
#63
Kirkland, WA 98034
Phone (425) 899-1860

12040 NE 128th St
#71
Kirkland, WA 98034

12040 NE 128th St
Ste 109
Kirkland, WA 98034

12040 NE 128th St
Ste 74
Kirkland, WA 98034

12040 NE 128th St
Ste Ms
Kirkland, WA 98034

12040 NE 128th St
Ste MS10
Kirkland, WA 98034

12040 NE 128th St
Ste MS105
Kirkland, WA 98034

12040 NE 128th St
Ste MS119
Kirkland, WA 98034

12040 NE 128th St
Ste MS3
Kirkland, WA 98034

12040 NE 128th St
Ste MS71
Kirkland, WA 98034

12040 NE 128th St
Stop 10
Kirkland, WA 98034

Practitioners & affiliated clinicians

Practitioners 672

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.

View all 672

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1902907165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102928",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911892928",
            "telephone_number": "425-899-3868",
            "fax_number": "425-899-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 214TH ST SE",
            "address_2": "SUITE 110",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218486",
            "telephone_number": "425-488-4988",
            "fax_number": "425-488-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2",
        "enumeration_date": "2006-09-26",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "HOWE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "425-899-2606"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CG8137",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CQ2437",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CJ9678",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CG2833",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7072358",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EvergreenHealth Medical Group Snohomish County",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EvergreenHealth Medical Group Snohomish County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.