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Organization

WESTERN WASHINGTON MEDICAL GROUP, INC PS

Active
Parent organization
WESTERN WASHINGTON MEDICAL GROUP
Other names
Western Wa Medical Group Dept of Endocrinology
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
8423 MUKILTEO SPEEDWAY STE 102, MUKILTEO, WA 98275-3237
(425) 412-4311
(425) 374-8896
Mailing address
1728 W MARINE VIEW DR STE 110, EVERETT, WA 98201-2094
(425) 412-4311
(425) 374-8896

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
601474013
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101673
LABOR & INDUSTRY
WA
05
7106347
WA
01
DA4340
RAILROAD MEDICARE
WA
Enumeration date
04/23/2007
Last updated
08/04/2023
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