Look up the most recent NPI and PECOS records

Federico Fenton Portillo

Internal Medicine

Allopathic & Osteopathic Physicians

(425) 261-2000 (866) 747-2455

PECOS Enrollment

Based on the most recent information from CMS, provider Federico Fenton Portillo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1891136842
Provider Type
Individual
Full Name
Fenton Portillo, Federico
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
7/7/2013
Last Updated
3/29/2021

Contact Information

Practice Location

1321 Colby Ave, Everett, WA 98201-1665

(425) 261-2000

Unlisted Fax

Mailing Location

PO Box 3360, Portland, OR 97208-3360

(866) 747-2455

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License MD60639341 Washington
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License R-9606 Iowa
Code 208M00000X	Description Hospitalist Allopathic & Osteopathic Physicians	License MD60639341 Washington

Federico Fenton Portillo

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Tsai, James C

Jensen, Phoebe