Eileen Joy Domingo

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP60765124 Issued in WA

Practice address

35105 Enchanted Pkwy S Ste G101
Federal Way, WA 98003-8379

Phone

(833) 411-5469

NPI assigned

Aug 14, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Eileen Joy Dela Cruz Domingo Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edomingo27282@yvfwc.direct-ci.com
• Direct secure messaging: edomingo459591@wm.providencedirect.org

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.

• 600 Stewart Medical Group, P.C.

  • Primary Care Clinic/Center
  • Seattle, WA
  • NPI 1487317954
  NPD

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1962801142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35105 ENCHANTED PKWY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038379",
            "telephone_number": "833-411-5469",
            "fax_number": "855-459-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35105 ENCHANTED PKWY S STE G101",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038379",
            "telephone_number": "833-411-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGO",
        "first_name": "EILEEN JOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OL60561517",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60765124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edomingo27282@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "510 W 1st Ave",
            "city": "Toppenish",
            "state": "WA",
            "country_code": "US",
            "postal_code": "989481564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EILEEN JOY",
            "last_name": "DELA CRUZ DOMINGO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steven Y Dodobara, DDS
• Dodobaras,D.D.S.,P.S.
• Marielouise S Dodson, LMHC
• Christine Dofredo, LMP
• Jordann Doler, LSWAIC
• Amanda Beth Dommermuth, LMP
• Christine Marie Domschot, BCBA, LBA
• Jean-Roberto Don, ND
• Dong W Han PLLC
• Dongwu Han DMD I PLLC

• Family Medicine Physician in Federal Way, WA
• Providers in Federal Way, 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 Mar 10, 2023; 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.