| Behavioral Health Resources | |
|
3857 Martin Way E Olympia WA 98506-5268 | |
| (360) 704-7170 | |
| (360) 704-7182 |
| Full Name | Behavioral Health Resources |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3857 Martin Way E, Olympia, Washington |
| Authorized Official Name and Position | Eric Jensen (CONTROLLER) |
| Authorized Official Contact | 3602367170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Health Resources 3857 Martin Way E Olympia WA 98506-5268 Ph: (360) 704-7170 | Behavioral Health Resources 3857 Martin Way E Olympia WA 98506-5268 Ph: (360) 704-7170 |
| NPI Number | 1093895203 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 12/27/2019 |
| Certification Date | 12/27/2019 |
| Medicare PECOS PAC ID | 7315848660 |
|---|---|
| Medicare Enrollment ID | O20040119000614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093895203 | NPI | - | NPPES |
| 1985308 | Medicaid | WA | |
| 9629577 | Medicaid | WA | |
| 7049257 | Medicaid | WA | |
| 9640525 | Medicaid | WA | |
| 1991603 | Medicaid | WA | |
| 1993088 | Medicaid | WA | |
| 1980192 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 600255953 (Washington) | Primary |
| Provider Name | Sarah E Leisenring |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609844836 PECOS PAC ID: 0749337715 Enrollment ID: I20090408000320 |
| Provider Name | Rebecca Joe Renn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457319071 PECOS PAC ID: 1951308758 Enrollment ID: I20100507000269 |
| Provider Name | William S Kelly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073626453 PECOS PAC ID: 3971633488 Enrollment ID: I20100610000103 |
| Provider Name | Miqueila Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700182631 PECOS PAC ID: 6002091303 Enrollment ID: I20110907001576 |
| Provider Name | Victoria A Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447219779 PECOS PAC ID: 6002878089 Enrollment ID: I20120509000101 |
| Provider Name | Lawrence M Martin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902919202 PECOS PAC ID: 4486818937 Enrollment ID: I20120613000054 |
| Provider Name | John S Kamin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558433185 PECOS PAC ID: 4880584622 Enrollment ID: I20130913000235 |
| Provider Name | John E Morris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851314603 PECOS PAC ID: 8123033487 Enrollment ID: I20130913000305 |
| Provider Name | Anneliese M Kraiger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285075457 PECOS PAC ID: 6204065758 Enrollment ID: I20140204001215 |
| Provider Name | Susan F Pascual |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225306574 PECOS PAC ID: 0749508372 Enrollment ID: I20150411000004 |
| Provider Name | Patrick C Gariety |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538371703 PECOS PAC ID: 0749582922 Enrollment ID: I20160105001526 |
| Provider Name | Anne Marie Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194255927 PECOS PAC ID: 4486082526 Enrollment ID: I20200324000487 |
| Provider Name | Linda Kaye Young |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033208731 PECOS PAC ID: 2860494754 Enrollment ID: I20200604002411 |
| Provider Name | Peter Charles Hausman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497234892 PECOS PAC ID: 2961887971 Enrollment ID: I20220912002245 |
| Provider Name | Dawn Marie Vanderhoef |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083648604 PECOS PAC ID: 1759341266 Enrollment ID: I20230131003504 |
| Provider Name | Kerry Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194006999 PECOS PAC ID: 3678740479 Enrollment ID: I20231019000826 |
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