Western Washington Medical Group

NPI #1194045542 in Bothell, Washington

Provider Information

NPI Number: 1194045542
Entity Type: Organization
Organization Name: Western Washington Medical Group
Primary Specialty: Internal Medicine
Enumeration Date: Jun 8, 2010
Last Updated: Nov 23, 2011

Practice Location

Address: 1909 214TH ST SE
Address 2: SUITE 211
City: Bothell
State: Washington
ZIP Code: 98021-4412
Phone: (425) 420-1655

Authorized Official

Name: JEROME TILLINGER
Title: CEO
Phone: (425) 259-4041

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary
Specialist	174400000X

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