Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Western Washington Medical Group

Organization Specialist · NPI 1194045542

Western Washington Medical Group provides Specialist services in Bothell, Washington. Licensed in Washington. Registered with an NPI since 2010.

Licensed in
WA
In the registry since
2010
Specialties on file
7

Practice location Address checks out

1909 214th St SE Ste 211
Bothell, WA 98021-4412 Not confirmed with CMS for 14 years — call before visiting
Phone: (425) 420-1655
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 207RE0101X (WA)
Specialist Taxonomy 174400000X · Licence 207RG0100X (WA)
Specialist Taxonomy 174400000X · Licence 207RC0000X (WA)
Specialist Taxonomy 174400000X · Licence 213E00000X (WA)
Specialist Taxonomy 174400000X · Licence 207Y00000X (WA)
Specialist Taxonomy 174400000X · Licence 291U00000X (WA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 207R00000X (WA)

Record details

NPI number1194045542
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerome Tillinger — Ceo · (425) 259-4041
NPI enumeratedJune 8, 2010
Last updated in NPPESNovember 23, 2011
Mailing address1728 W Marine View Dr, Suite 110, Everett, WA 98201-2094

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