# WESTERN WASHINGTON MEDICAL GROUP, INC PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WWMG Dept of Imaging
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720430903
- **Authorized official:** KIM HOLSTEIN (DIRECTOR)
- **Authorized official phone:** (425) 259-4041

## Contact information

- **Practice address:** 3822 COLBY AVE, SUITE 100, EVERETT, WA 98201-4913
- **Practice address phone:** (425) 259-4041
- **Mailing address:** 1728 W MARINE VIEW DR, SUITE 110, EVERETT, WA 98201-2094
- **Mailing address phone:** (425) 259-4041

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/12/2016
- **Last updated:** 07/10/2017