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

Dr. Micah James Roland Mack, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1447745450

Dr. Micah James Roland Mack, DO is an Internal Medicine in Bellevue, Washington. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2018, 8 years ago. Practices with Virginia Mason Medical Center, a 867-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
8
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
WA
In the registry since
2018
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

11695 NE 4th St
Bellevue, WA 98004-5268
Phone: (425) 637-1855
Fax: (206) 344-7970
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence OP61175176 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1447745450
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 22, 2018
Last updated in NPPESNovember 16, 2021
Certification dateNovember 16, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2018 (8 years in practice)
Group practice Virginia Mason Medical Center — 867 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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