Fairfax Physician Group | |
10200 Ne 132nd St Kirkland WA 98034-2831 | |
(425) 821-2000 | |
Not Available |
Full Name | Fairfax Physician Group |
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Speciality | Psychiatry & Neurology |
Location | 10200 Ne 132nd St, Kirkland, Washington |
Authorized Official Name and Position | Peggy Trachte (BUSINESS OFFICE DIRECTOR) |
Authorized Official Contact | 4252841708 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fairfax Physician Group 10200 Ne 132nd St Kirkland WA 98034-2831 Ph: (425) 821-2000 | Fairfax Physician Group 10200 Ne 132nd St Kirkland WA 98034-2831 Ph: (425) 821-2000 |
NPI Number | 1104959097 |
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Provider Enumeration Date | 03/13/2007 |
Last Update Date | 12/12/2011 |
Medicare PECOS PAC ID | 1153231857 |
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Medicare Enrollment ID | O20031120000445 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104959097 | NPI | - | NPPES |
7104326 | Medicaid | WA | |
7159908 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Patrick Mathiasen |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1316962145 PECOS PAC ID: 4284627373 Enrollment ID: I20040405001603 |
Provider Name | Brian D Coleman |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1861575607 PECOS PAC ID: 5193702868 Enrollment ID: I20040630000953 |
Provider Name | Melissa L Rubin |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1811043441 PECOS PAC ID: 4880671510 Enrollment ID: I20040701000379 |
Provider Name | Deborah L Seidel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992736847 PECOS PAC ID: 5890764484 Enrollment ID: I20040930000213 |
Provider Name | Shona E Lowell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598710840 PECOS PAC ID: 3779523162 Enrollment ID: I20050504001274 |
Provider Name | Beth C Hutchings |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407867112 PECOS PAC ID: 4284676552 Enrollment ID: I20050526000207 |
Provider Name | Angela S Rideout |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750423554 PECOS PAC ID: 1759398811 Enrollment ID: I20060315000568 |
Provider Name | Eric J Roedel |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1588717375 PECOS PAC ID: 0749299980 Enrollment ID: I20060417000166 |
Provider Name | Syed J Mustafa |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1609883180 PECOS PAC ID: 2365533544 Enrollment ID: I20070801000767 |
Provider Name | Syed Kamal Mustafa |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1316954894 PECOS PAC ID: 3375632193 Enrollment ID: I20071203000026 |
Provider Name | Jessica J Jajesnica |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780779827 PECOS PAC ID: 9931273638 Enrollment ID: I20080729000592 |
Provider Name | Patricia K Fray |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881835163 PECOS PAC ID: 2163571944 Enrollment ID: I20090527000589 |
Provider Name | Tasha Elisa Morris |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1700957115 PECOS PAC ID: 8426082520 Enrollment ID: I20090909000487 |
Provider Name | Polly H Richardson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053391003 PECOS PAC ID: 2264579010 Enrollment ID: I20091027000533 |
Provider Name | Tatiana I Sadak |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235466517 PECOS PAC ID: 7517094170 Enrollment ID: I20100430000071 |
Provider Name | Mustapha I Hydara |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972831451 PECOS PAC ID: 0446381446 Enrollment ID: I20100707000369 |
Provider Name | Linda Shin Milhoan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306036793 PECOS PAC ID: 5890989859 Enrollment ID: I20101103000866 |
Provider Name | Amy O Zachara |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124337969 PECOS PAC ID: 0446447882 Enrollment ID: I20101210000066 |
Provider Name | Rachel A Bates |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154619054 PECOS PAC ID: 6002087574 Enrollment ID: I20110914000585 |
Provider Name | Brian E Waiblinger |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1750350443 PECOS PAC ID: 6507033990 Enrollment ID: I20120126000156 |
Provider Name | Patricia Garrison |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730489972 PECOS PAC ID: 3375722374 Enrollment ID: I20120221000861 |
Provider Name | Catherine E Webb |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194061614 PECOS PAC ID: 0446404636 Enrollment ID: I20130218000481 |
Provider Name | Yen T Nguyen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356665947 PECOS PAC ID: 2567602394 Enrollment ID: I20130628000017 |
Provider Name | Olga G Abramova |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285036228 PECOS PAC ID: 4688996002 Enrollment ID: I20141212002205 |
Provider Name | Gemy George |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144619099 PECOS PAC ID: 2163733593 Enrollment ID: I20150625001533 |
Provider Name | Rache M Mureau-haines |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417300450 PECOS PAC ID: 2062708738 Enrollment ID: I20160906001675 |
Provider Name | Patrick Muturi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962876839 PECOS PAC ID: 2062791056 Enrollment ID: I20161115001505 |
Provider Name | Sid H Siahpush |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1104036631 PECOS PAC ID: 8527246719 Enrollment ID: I20161215001688 |
Provider Name | Ji-young Kim |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164974978 PECOS PAC ID: 5799066973 Enrollment ID: I20161230000158 |
Provider Name | Murtuza Vali |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1366515009 PECOS PAC ID: 1658427422 Enrollment ID: I20170607003050 |
Provider Name | Baijie Wang |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164952628 PECOS PAC ID: 9638449614 Enrollment ID: I20170725000206 |
Provider Name | Ebrima Bangura |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093246928 PECOS PAC ID: 6103197520 Enrollment ID: I20170822001735 |
Provider Name | Thor Tangvald |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1235287954 PECOS PAC ID: 0143269258 Enrollment ID: I20171006001311 |
Provider Name | Margo Shultes Von Schlageter |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1255422549 PECOS PAC ID: 8628381472 Enrollment ID: I20171027001376 |
Provider Name | Taisia Alexandra Jignea |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316469208 PECOS PAC ID: 2860768348 Enrollment ID: I20171027002076 |
Provider Name | Mark D Kline |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1477670495 PECOS PAC ID: 9537421359 Enrollment ID: I20180314002248 |
Provider Name | Arvinder Kaul |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1396792578 PECOS PAC ID: 4486680121 Enrollment ID: I20180615001143 |
Provider Name | Drew William Calhoun |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1992144984 PECOS PAC ID: 6800149188 Enrollment ID: I20181102002437 |
Provider Name | Paul S Cagatin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679066278 PECOS PAC ID: 4880948769 Enrollment ID: I20181112002288 |
Provider Name | Olena Sergiyivna Fox |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033509260 PECOS PAC ID: 0941534648 Enrollment ID: I20190701000781 |
Provider Name | April Nicole Hinsberger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225520539 PECOS PAC ID: 4486985926 Enrollment ID: I20191014002727 |
Provider Name | Nikolous Fox |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336676105 PECOS PAC ID: 6608207527 Enrollment ID: I20200510000250 |
Provider Name | Rachel R Mccluskey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437211711 PECOS PAC ID: 7810328309 Enrollment ID: I20200518001502 |
Provider Name | Aaron Kevin Andersen |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1679821334 PECOS PAC ID: 6901020338 Enrollment ID: I20201109002610 |
Provider Name | Peter D Reiss |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1669855409 PECOS PAC ID: 0749527133 Enrollment ID: I20201112000455 |
Provider Name | Xin Wu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912539099 PECOS PAC ID: 6901218478 Enrollment ID: I20201208001258 |
Provider Name | Liana Stepanyan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437796240 PECOS PAC ID: 4082026844 Enrollment ID: I20201218002509 |
Provider Name | Okechukwu Kene Aneke |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568046449 PECOS PAC ID: 3173911054 Enrollment ID: I20211026001516 |
Provider Name | Natnael Gebeyehu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528700309 PECOS PAC ID: 9931565322 Enrollment ID: I20230509001669 |
Provider Name | Joy C Uduehi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770249716 PECOS PAC ID: 2163320367 Enrollment ID: I20230605003168 |
Provider Name | Wioleta E Bongiorno |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699345926 PECOS PAC ID: 7517324650 Enrollment ID: I20230606001438 |
Provider Name | Ibrahim A Ibrahim |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255004180 PECOS PAC ID: 9830556810 Enrollment ID: I20230606003486 |
Provider Name | David N Njenga |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518691286 PECOS PAC ID: 0042677031 Enrollment ID: I20230607000381 |
Provider Name | Leulseged Gebrekidan Amare |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730802661 PECOS PAC ID: 0648637504 Enrollment ID: I20230607003280 |
Provider Name | Matthew C Parker |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1649620089 PECOS PAC ID: 6507107182 Enrollment ID: I20230925003832 |
Kailani Counseling & Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12220 113th Ave Ne Ste 210, Kirkland, WA 98034 Phone: 206-312-7426 Fax: 206-339-1550 | |
Ioana Diaconu, Md, Ps Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 620 Kirkland Way, 200, Kirkland, WA 98033 Phone: 425-889-5045 | |
Timothy A Rogge, Md, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10200 Ne 132nd St, Kirkland, WA 98034 Phone: 425-821-2000 | |
Relationships, Bodies, And Minds By Design Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9757 Ne Juanita Dr, Suite 206, Kirkland, WA 98034 Phone: 425-736-7911 | |
Ryan Q Patterson Ma Lmhc Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11415 Ne 128th St, Suite 30, Kirkland, WA 98034 Phone: 425-205-9332 Fax: 888-232-6779 | |
Lake Counseling & Consulting Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10415 Ne 37th Cir Bldg 4, Kirkland, WA 98033 Phone: 206-590-1331 | |
Larry W. Einspahr M.d. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5400 Carillon Pt Bldg 5000, 4th Floor, Kirkland, WA 98033 Phone: 206-999-2486 Fax: 360-871-1942 |