Eagle Harbor Family Medicine PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AP20004070 Issued in WA

Legal business name

EAGLE HARBOR FAMILY MEDICINE PLLC

Practice address

600 Winslow Way E Ste 114
Bainbridge Island, WA 98110-3252

Phone

(206) 842-5979

Fax

(206) 842-4124

NPI assigned

Oct 17, 2017

Last updated

Oct 17, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Linda Marie Pedersen, ARNPNPI 1164572590

Title

Owner

Phone

(360) 626-3133

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Linda Marie Pedersen, MNARNP

  • Family Nurse Practitioner
  • Bainbridge Island, WA
  • NPI 1164572590
  Authorized official Same address or phone
• Audrey C Van Voorhis, ARNP

  • Specialist
  • Bainbridge Island, WA
  • NPI 1447284690
  NPD (past)

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1912418914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WINSLOW WAY E STE 114",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981103252",
            "telephone_number": "206-842-5979",
            "fax_number": "206-842-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WINSLOW WAY E STE 114",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981103252",
            "telephone_number": "206-842-5979",
            "fax_number": "206-842-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HARBOR FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-17",
        "last_updated": "2017-10-17",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-626-3133",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "AP20004070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberta Dueno
• Trisia Rose Dumpit, APRN
• Keriann Dunning
• Emily Nicole Durban, DPT
• Eagle Harbor Chiropractic Inc.P.S.
• Eagle Harbor Healthcare LLC (Bainbridge Island Health and Rehabilitation Center)
• Susan Eakins
• Erin D'Arcy Earle, MA LMHCA
• Philip Warren Early, MD
• Catherine J Edwards, M.D.

• Family Medicine Physician in Bainbridge Island, WA
• Providers in Bainbridge Island, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.