WESTERN WA MEDICAL GROUP DEPT OF NEPHROLOGY – NPI #1417175811
Internal Medicine

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Health Care Provider Taxonomy Code for Internal Medicine

WESTERN WA MEDICAL GROUP DEPT OF NEPHROLOGY is a provider located in EVERETT, WA. NPPES has assigned the NPI number 1417175811 to WESTERN WA MEDICAL GROUP DEPT OF NEPHROLOGY on April 23, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “WESTERN WA MEDICAL GROUP DEPT OF NEPHROLOGY” is a dba name, the actual legal business name for this organization is WESTERN WASHINGTON MEDICAL GROUP, INC PS. The primary taxonomy selected by this provider is 207RN0300X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Nephrology

The NPI profile was previously updated about 2 years ago on May 24, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WESTERN WA MEDICAL GROUP DEPT OF NEPHROLOGY below.

NPI Profile for
WESTERN WASHINGTON MEDICAL GROUP, INC PS

NPI Number
1417175811
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
WESTERN WASHINGTON MEDICAL GROUP, INC PS
Doing Business As (dba): WESTERN WA MEDICAL GROUP DEPT OF NEPHROLOGY
Primary location
12728 19TH AVE SE STE 300
EVERETT, WA 98208-6676
Phone: (425) 258-6801 Fax: (425) 258-1944
Mailing address
Same as primary location
Organization Subpart
Yes - WESTERN WA MEDICAL GROUP DEPT OF NEPHROLOGY is subpart of another organization.
Authorized Official
VICKI MCGINNIS
HIPPA PRIVACY OFFICER
Phone: (425) 259-4041
Updated
Certification Date
May 24, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for WESTERN WA MEDICAL GROUP DEPT OF NEPHROLOGY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
otherLABOR & INDUSTRYWA0050081
otherRAILROAD MEDICAREWACJ9333
medicaidWA7057029
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RN0300X
- Internal Medicine / Nephrology (Primary)		 WA 601474013

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.