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

Western Washington Medical Group Inc Ps

Organization Family Medicine Physician · NPI 1780522615

Western Washington Medical Group Inc Ps provides Family Medicine Physician services in Bothell, Washington. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1909 214th St SE Ste 205
Bothell, WA 98021-4415
Phone: (425) 317-8025
Fax: (425) 317-9516
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1780522615
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationWestern Washington Medical Group Inc Ps
Authorized official David Russian — Ceo · (425) 259-4041
NPI enumeratedMarch 23, 2026
Last updated in NPPESMay 8, 2026
Certification dateMay 8, 2026
Mailing address1728 W Marine View Dr Ste 110, Everett, WA 98201-2094

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