# WESTERN WASHINGTON MEDICAL GROUP, INC PS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WESTERN WASHINGTON MEDICAL GROUP
- **Other names:** Western Wa Med Grp Dept of Pulmonary, Sleep Disorders, Critical Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1215155619
- **Legal business name:** WESTERN WASHINGTON MEDICAL GROUP
- **Authorized official:** MS. VICKI MCGINNIS (PRIVACY OFFICER)
- **Authorized official phone:** (425) 259-4041

## Contact information

- **Practice address:** 12728 19TH AVE SE, SUITE 300, EVERETT, WA 98208-6526
- **Practice address phone:** (425) 252-1116
- **Practice address fax:** (425) 252-1118
- **Mailing address:** 12728 19TH AVE SE, SUITE 300, EVERETT, WA 98208-6526
- **Mailing address phone:** (425) 252-1116
- **Mailing address fax:** (425) 252-1118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | 601474013 | WA | — |
| 207RP1001X | Pulmonary Disease Physician | 601474013 | WA | Yes |

## Other

- **Enumeration date:** 04/23/2007
- **Last updated:** 02/23/2016