Dr Geraldine Anne Peterdy, MD | |
112 S Greenridge Dr, Liberty Lake, WA 99019-9566 | |
(509) 255-1000 | |
Not Available |
Full Name | Dr Geraldine Anne Peterdy |
---|---|
Gender | Female |
Speciality | Pathology |
Experience | 31 Years |
Location | 112 S Greenridge Dr, Liberty Lake, Washington |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104864792 | NPI | - | NPPES |
8331084 | Medicaid | WA | |
AB 35581 | Other | WA | MEDICARE WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ZD0900X | Pathology - Dermatopathology | MD00041937 (Washington) | Secondary |
207ZP0101X | Pathology - Anatomic Pathology | MD00041937 (Washington) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Providence Portland Medical Center | Portland, OR | Hospital |
Providence St Vincent Medical Center | Portland, OR | Hospital |
Providence Newberg Medical Center | Newberg, OR | Hospital |
Providence Willamette Falls Medical Center | Oregon city, OR | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Providence Health And Services Oregon | 3072415652 | 47 |
Providence Health And Services - Oregon | 5294901922 | 51 |
Providence Health And Services Oregon | 5395656284 | 115 |
Providence Health And Services Oregon | 9335057447 | 137 |
Entity Name | Providence Health & Services Oregon |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003991845 PECOS PAC ID: 5395656284 Enrollment ID: O20031113000626 |
Entity Name | Providence Health & Services Oregon |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114015971 PECOS PAC ID: 9335057447 Enrollment ID: O20031117000153 |
Entity Name | Providence Health & Services Oregon |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093976243 PECOS PAC ID: 3476450560 Enrollment ID: O20031217000186 |
Entity Name | Providence Health & Services Oregon |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578500492 PECOS PAC ID: 1557260106 Enrollment ID: O20040102000768 |
Entity Name | Providence Health & Services Oregon |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366536963 PECOS PAC ID: 6103728753 Enrollment ID: O20040123000371 |
Entity Name | Providence Health & Services Oregon |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952482275 PECOS PAC ID: 3072415652 Enrollment ID: O20040123000519 |
Entity Name | Providence Health & Services Oregon |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053862714 PECOS PAC ID: 7315856010 Enrollment ID: O20040304001330 |
Entity Name | Providence Health & Services - Oregon |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912282369 PECOS PAC ID: 5294901922 Enrollment ID: O20120319000430 |
Mailing Address | Practice Location Address |
---|---|
Dr Geraldine Anne Peterdy, MD Po Box 727, Allied Pathology, Pc, Liberty Lake, WA 99019-0727 Ph: (509) 255-1000 | Dr Geraldine Anne Peterdy, MD 112 S Greenridge Dr, Liberty Lake, WA 99019-9566 Ph: (509) 255-1000 |