# ISSAQUAH MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912043720
- **Authorized official:** MICHAEL P HOURIGAN (ADMINISTRATOR)
- **Authorized official phone:** (425) 291-9562

## Contact information

- **Practice address:** 450 NW GILMAN BLVD STE 201, ISSAQUAH, WA 98027-2483
- **Practice address phone:** (425) 391-0705
- **Practice address fax:** (425) 391-9562
- **Mailing address:** 450 NW GILMAN BLVD STE 201, ISSAQUAH, WA 98027-2483
- **Mailing address phone:** (425) 391-0705
- **Mailing address fax:** (425) 391-9562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OP00000637 | WA | Yes |

## Other

- **Enumeration date:** 01/29/2007
- **Last updated:** 08/22/2020