# MADRONA MEDICAL GROUP, P.S.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Madrona Endoscopy Suite
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659362143
- **Authorized official:** SANDY MELLOTT (DIRECTOR CLINICAL SERVICES)
- **Authorized official phone:** (360) 738-2200

## Contact information

- **Practice address:** 4545 CORDATA PKWY, BELLINGHAM, WA 98226-7123
- **Practice address phone:** (360) 738-2200
- **Practice address fax:** (360) 753-5673
- **Mailing address:** 4545 CORDATA PKWY, BELLINGHAM, WA 98226-7123
- **Mailing address phone:** (360) 738-2200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 601644971 | WA | Yes |

## Other

- **Enumeration date:** 11/02/2005
- **Last updated:** 10/06/2008