Mary Shannon Sumner, | |
820 Memorial St Ste 1, Prosser, WA 99350-2504 | |
(509) 786-2010 | |
(509) 788-1794 |
Full Name | Mary Shannon Sumner |
---|---|
Gender | Female |
Speciality | Counselor |
Location | 820 Memorial St Ste 1, Prosser, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538553300 | NPI | - | NPPES |
1020986 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | LH60802996 (Washington) | Primary |
Entity Name | Port Gamble S'klallam Tribe |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760428650 PECOS PAC ID: 6204737927 Enrollment ID: O20040115001158 |
Mailing Address | Practice Location Address |
---|---|
Mary Shannon Sumner, 820 Memorial St Ste 1, Prosser, WA 99350-2504 Ph: (509) 786-2010 | Mary Shannon Sumner, 820 Memorial St Ste 1, Prosser, WA 99350-2504 Ph: (509) 786-2010 |
Maria Guadalupe Ayala, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1109 Meade Ave, Prosser, WA 99350 Phone: 509-786-3323 | |
Ronda Eucker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 804 Court St, Prosser, WA 99350 Phone: 509-786-2477 | |
Dixie L George, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 30 Merlot Drive, Suite F, Prosser, WA 99350 Phone: 509-303-9947 | |
Ed Thornbrugh, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1031 Burgundy Pl, Prosser, WA 99350 Phone: 509-786-4196 | |
Jorge Sanchez, Counselor Medicare: Not Enrolled in Medicare Practice Location: 133814 W Shelby Rd, Prosser, WA 99350 Phone: 509-303-0501 | |
Brandi Thornbrugh, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1031 Burgundy Pl, Prosser, WA 99350 Phone: 509-786-4196 |