WESTERN WASHINGTON MEDICAL GROUP INC PS
NPI 1780522615
Family Medicine in Bothell, WA

Q: What is Western Washington Medical Group Inc Ps's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since March 23, 2026

1909 214TH ST SE STE 205, BOTHELL, WA 98021(425) 317-8025(425) 317-9516 Get Directions Write a Review

NPPES record last updated: May 8, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 8, 2026, Apr 22, 2026, Apr 17, 2026 and 1 more (4 updates tracked since 2026).

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About Western Washington Medical Group Inc Ps NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WESTERN WASHINGTON MEDICAL GROUP INC PS (NPI 1780522615) is a healthcare organization registered as a family medicine in Bothell, Washington and active in the NPI registry since March 2026. The organization lists David Russian, Ceo, as its authorized official.

NPPES Registry Identity

NPI1780522615

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameWESTERN WASHINGTON MEDICAL GROUP INC PS

Location Address1909 214TH ST SE STE 205Bothell, WA 98021-4415

Mailing Address1728 W Marine View Dr Ste 110Everett, WA 98201-2094 · (425) 317-8025 · Fax (425) 317-9516

Phone(425) 317-8025

Fax(425) 317-9516

Organization SubpartYes

Authorized OfficialDavid RussianCeo · (425) 259-4041

Enumeration DateMarch 23, 2026

Last NPPES UpdateMay 8, 20264 updates tracked since enumeration

NPPES CertifiedMay 8, 2026

✔ NPI 1780522615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1909 214TH ST SE STE 205, Bothell, WA 98021

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Western Washington Medical Group Inc Ps is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 90 clinicians reassign Medicare billing to Western Washington Medical Group Inc Ps, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 41 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 21

Nurse Practitioner23

Family Practice11

Pulmonary Disease9

Critical Care (Intensivists)8

Orthopedic Surgery8

Gastroenterology6

Cardiovascular Disease (Cardiology)4

Clinical Psychologist3

13 other specialties18

Nearest to this location (20)

See all 90

Rosemarie Kennaley, MD

Family Practice

NPI 1205082211

1909 214TH ST SE STE 205
Bothell, WA 98021

(425) 420-1657

✔ PECOS✔ Accepts MedicareSame address

Kerlan Wolsey, M.D.

Pulmonary Disease

NPI 1154419588

1909 214TH ST SE STE 300
Bothell, WA 98021

(425) 412-7200

✔ PECOS✔ Accepts MedicareSame address

Jeff Peterson, MD

Rheumatology

NPI 1467491076

19119 N CREEK PKWY STE 102
Bothell, WA 98011

(425) 923-7945

✔ PECOS✔ Accepts Medicare2.8 mi

Shoaib Fakhri, MD

Pulmonary Disease

NPI 1992200844

12728 19TH AVE SE STE 300
Everett, WA 98208

(425) 252-1116