| Clear Mental Health Llc | |
|
2603 Bridgeport Way W Ste F University Place WA 98466-4724 | |
| (253) 666-6780 | |
| (253) 666-6793 |
| Full Name | Clear Mental Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2603 Bridgeport Way W Ste F, University Place, Washington |
| Authorized Official Name and Position | Ajainder Shergill (OWNER) |
| Authorized Official Contact | 3603341882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Mental Health Llc 9000 Crow Canyon Rd Ste S360 Danville CA 94506-1189 Ph: () - | Clear Mental Health Llc 2603 Bridgeport Way W Ste F University Place WA 98466-4724 Ph: (253) 666-6780 |
| NPI Number | 1851926992 |
|---|---|
| Provider Enumeration Date | 03/09/2020 |
| Last Update Date | 08/11/2020 |
| Certification Date | 08/11/2020 |
| Medicare PECOS PAC ID | 5890115802 |
|---|---|
| Medicare Enrollment ID | O20201013002059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851926992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Amy J Hiestand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124140116 PECOS PAC ID: 3678670031 Enrollment ID: I20070521000238 |
| Provider Name | Ajainder Shergill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366648222 PECOS PAC ID: 6305991928 Enrollment ID: I20090903000513 |
| Provider Name | Audry G Gorman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902828155 PECOS PAC ID: 2264759109 Enrollment ID: I20190321002787 |
| Provider Name | Kimberly Ann Cochran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811483480 PECOS PAC ID: 5092067207 Enrollment ID: I20200619002246 |
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