# WESTERN WASHINGTON MEDICAL GROUP, INC PS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WESTERN WASHINGTON MEDICAL GROUP
- **Other names:** Western Washington Medical Group Endoscopy Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1427005313
- **Legal business name:** WESTERN WASHINGTON MEDICAL GROUP
- **Authorized official:** VICKI MCGINNIS (HIPAA PRIVACY OFFICER)
- **Authorized official phone:** (425) 259-4041

## Contact information

- **Practice address:** 12800 BOTHELL EVERETT HWY, SUITE 200, EVERETT, WA 98208-6642
- **Practice address phone:** (425) 259-3122
- **Mailing address:** 4225 HOYT AVE, SUITE A, EVERETT, WA 98203-2351
- **Mailing address phone:** (425) 259-3122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |
| 261QE0800X | Endoscopy Clinic/Center | 601 474 013 | WA | — |

## Other

- **Enumeration date:** 05/27/2006
- **Last updated:** 02/23/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0150248 | LABOR AND INDUSTRY | WA |
| 01 | — | 490002852 | RAILROAD MEDICARE | WA |
| 05 | — | 7068356 | — | WA |