Organization
WESTERN WASHINGTON MEDICAL GROUP, INC PS
Active
Parent organization
WESTERN WASHINGTON MEDICAL GROUP
Other names
Western Wa Medical Group Dept of ENT
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
3125 COLBY AVE STE J, EVERETT, WA 98201-4032
(425) 791-3093
(425) 791-3094
Mailing address
1728 W MARINE VIEW DR STE 110, EVERETT, WA 98201-2094
(425) 791-3093
(425) 791-3094
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
601474013
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7127780
—
WA
01
—
DE3720
RAILROAD MEDICARE
WA
Enumeration date
04/23/2007
Last updated
08/04/2023
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