Immune Disease Treatment Services PLLC

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

MD00027570 Issued in WA

Legal business name

IMMUNE DISEASE TREATMENT SERVICES PLLC

Practice address

14100 SE 36TH St Ste 105
Bellevue, WA 98006-1657

Phone

(425) 378-0110

Fax

(425) 378-0220

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Carl J Brodie III, M.D.

Title

Medical Doctor Owner

Phone

(425) 378-0110

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982781225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 SE 36TH ST STE 105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061657",
            "telephone_number": "425-378-0110",
            "fax_number": "425-378-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 SE 36TH ST STE 105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061657",
            "telephone_number": "425-378-0110",
            "fax_number": "425-378-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMUNE DISEASE TREATMENT SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRODIE",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DOCTOR OWNER",
        "authorized_official_telephone_number": "425-378-0110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "WA",
            "license": "MD00027570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Im, DDS
• Jelissa Iman-Olea
• Brian L Imber, PSYCHOLOGIST, LMHC
• Kathryn Marie Imberg, D.O.
• Maria Lee Imbesi, PA-C
• Annie Vang Imoto
• Julia K Imoto, LMP
• Celine Impert, ARNP
• Implant & Periodontic Specialists
• In Focus Eyecare NW, Inc.

• Rheumatology Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Rheumatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.