| Lutheran Community Services Northwest | |
|
4040 S 188th St Ste 300 Seatac WA 98188-5070 | |
| (206) 816-3253 | |
| (206) 838-2680 |
| Full Name | Lutheran Community Services Northwest |
|---|---|
| Speciality | Clinic/Center |
| Location | 4040 S 188th St Ste 300, Seatac, Washington |
| Authorized Official Name and Position | Shelia Clark (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5412013973 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Community Services Northwest 4040 S 188th St Ste 300 Seatac WA 98188-5070 Ph: (206) 816-3253 | Lutheran Community Services Northwest 4040 S 188th St Ste 300 Seatac WA 98188-5070 Ph: (206) 816-3253 |
| NPI Number | 1962628297 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 06/27/2024 |
| Certification Date | 06/27/2024 |
| Medicare PECOS PAC ID | 1254237522 |
|---|---|
| Medicare Enrollment ID | O20050408000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962628297 | NPI | - | NPPES |
| Provider Name | Susan Jamiel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336251818 PECOS PAC ID: 0345215943 Enrollment ID: I20040827000526 |
| Provider Name | Sharon D O Brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346385135 PECOS PAC ID: 2668487885 Enrollment ID: I20060209000203 |
| Provider Name | Lakew Woldetsadik Adnew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710389846 PECOS PAC ID: 5991051708 Enrollment ID: I20180710001624 |
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