Northwest Physical Medicine PS

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA60322491 Issued in WA

Legal business name

NORTHWEST PHYSICAL MEDICINE PS

Practice address

10655 NE 4TH St Ste 101
Bellevue, WA 98004-5022

Phone

(425) 455-2225

Fax

(425) 454-7767

NPI assigned

Mar 20, 2014

Last updated

Mar 20, 2014By 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

Raymon Kooner, D,C,

Title

Owner

Phone

(425) 455-2225

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395273600000",
    "number": "1972920502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10655 NE 4TH ST STE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045022",
            "telephone_number": "425-455-2225",
            "fax_number": "425-454-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10655 NE 4TH ST STE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045022",
            "telephone_number": "425-455-2225",
            "fax_number": "425-454-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PHYSICAL MEDICINE PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-20",
        "last_updated": "2014-03-20",
        "status": "A",
        "authorized_official_last_name": "KOONER",
        "authorized_official_first_name": "RAYMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-455-2225",
        "authorized_official_credential": "D,C,"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA60322491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Neuropsychology Learning and Behavioral Services
• Northwest Outpatient Anesthesia PLLC
• Northwest Pain Consultants PLLC
• Northwest Pediatric Eye Care P.S.
• Northwest Physical Medicine PS (Bellevue Wellness)
• Northwest Physicians Laboratories
• Northwest Podiatry, PLLC
• Northwest Rehabilitation Associates, Inc., PS
• Northwest Solstice Counseling, PLLC
• Northwest Spine & Sports Physicians

• Specialist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.