| Western Washington Medical Group, Inc Ps | |
|
1728 W Marine View Dr Suite 110 Everett WA 98201-2094 | |
| (425) 259-4041 | |
| (425) 252-6642 |
| Full Name | Western Washington Medical Group, Inc Ps |
|---|---|
| Speciality | Internal Medicine |
| Location | 1728 W Marine View Dr, Everett, Washington |
| Authorized Official Name and Position | Vicki M Mcginnis (PRIVACY OFFICER) |
| Authorized Official Contact | 4252594041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Washington Medical Group, Inc Ps 1728 W Marine View Dr Suite 110 Everett WA 98201-2094 Ph: (425) 259-4041 | Western Washington Medical Group, Inc Ps 1728 W Marine View Dr Suite 110 Everett WA 98201-2094 Ph: (425) 259-4041 |
| NPI Number | 1023065919 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 03/02/2016 |
| Medicare PECOS PAC ID | 7517870314 |
|---|---|
| Medicare Enrollment ID | O20040310000927 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023065919 | NPI | - | NPPES |
| Provider Name | Maiyen T Hawkins |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841446655 PECOS PAC ID: 6709012693 Enrollment ID: I20131125000818 |
| Provider Name | Justin R Cuschieri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871787663 PECOS PAC ID: 6709063720 Enrollment ID: I20141120002559 |
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