MEDICARE: CROSSOVER HEALTH MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1457200453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CROSSOVER HEALTH MEDICAL GROUP

Provider Business Mailing Address
First Line	:	1111 LAKE WASHINGTON BLVD N BLDG 3
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98056-2691
Country	:	US
Telephone Number	:	866-271-3589
Fax Number	:

Provider Business Practice Location Address
First Line	:	1111 LAKE WASHINGTON BLVD N BLDG 3
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98056-2691
Country	:	US
Telephone Number	:	866-271-3589
Fax Number	:

Authorized Official
Title or Position	:	CRED MANAGER
Name	:	JENETTE HUNTER
Credential	:
Telephone Number	:	971-500-2661

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

Similar Medicare Providers

1275492464 — CLOSE KNIT COUNSELING, PLLC
Practice Location Address:

4100 LAKE WASHINGTON BLVD N APT C102
RENTON, WA
98056-1588

Practice Phone: 425-522-2440
Practice Fax:

1144992850 — NATALIE GOOBES
Practice Location Address:

4100 LAKE WASHINGTON BLVD N APT C102
RENTON, WA
98056-1588

Practice Phone: 425-653-4900
Practice Fax:

1801754213 — SALLY KANG
Practice Location Address:

3704 NE 9TH CT
RENTON, WA
98056-3815

Practice Phone: 425-900-5666
Practice Fax: 425-900-5925

1881551786 — STEPHANIE FERRARO
Practice Location Address:

3704 NE 9TH CT
RENTON, WA
98056-3815

Practice Phone: 425-900-5666
Practice Fax: 425-900-5925

1942200217 — MS. DALE J FISHER LMHC
Practice Location Address:

401 OLYMPIA AVE NE UNIT 26
RENTON, WA
98056-4119

Practice Phone: 425-255-4331
Practice Fax: 425-255-3311

1386631877 — DOC ROBIN D PS
Practice Location Address:

3901 NE 4TH ST , SUITE 109
RENTON, WA
98056-4100

Practice Phone: 425-277-0577
Practice Fax: 425-277-0652

Directions to “CROSSOVER HEALTH MEDICAL GROUP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.