Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Western Washington Medical Group Inc Ps

Organization Family Medicine Physician · NPI 1780522615

Western Washington Medical Group Inc Ps is a Family Medicine Physician 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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