Organization
WESTERN WASHINGTON MEDICAL GROUP
Active
Parent organization
WESTERN WASHINGTON MEDICAL GROUP
Other names
Western Washington Medical Group Dept of Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN WASHINGTON MEDICAL GROUP
Authorized official
MS. VICKI MCGINNIS (PRIVACY OFFICER)
(425) 740-4148
Entity
Organization
Contact information
Practice address
3216 NORTON AVE STE 202, EVERETT, WA 98201-4290
(425) 259-3181
(425) 258-3179
Mailing address
3216 NORTON AVE STE 202, EVERETT, WA 98201-4290
(425) 259-3181
(425) 258-3179
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
601474013
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0049980
LABOR & INDUSTRIES
WA
05
—
7056997
—
WA
01
—
CS8495
RAILROAD MEDICARE
WA
Enumeration date
04/23/2007
Last updated
12/28/2010
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