Organization
WESTERN WASHINGTON MEDICAL GROUP, INC PS
Active
Organization
WESTERN WASHINGTON MEDICAL GROUP, INC PS
Active
Parent organization
WESTERN WASHINGTON MEDICAL GROUP
Other names
Western Wa Medical Group Dept of Rheumatology
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN WASHINGTON MEDICAL GROUP
Authorized official
AMELIA EDENS (DIRECTOR OF PATIENT FINANCIAL SVCS)
(425) 740-4142
Entity
Organization
Contact information
Practice address
4225 HOYT AVE STE C, EVERETT, WA 98203-2351
(425) 252-8375
(425) 252-8364
Mailing address
1728 W MARINE VIEW DR STE 110, EVERETT, WA 98201-2094
(425) 259-4041
(425) 252-6642
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
601474013
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0141951
LABOR & INDUSTRY
WA
05
—
7103641
—
WA
01
—
DC9098
RAILROAD MEDICARE
WA
Enumeration date
04/23/2007
Last updated
08/04/2023
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