| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 10 Dnr Road, Mcgrath, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 35198 Seattle WA 98124-5198 Ph: () - | 10 Dnr Road Mcgrath AK 99627 Ph: (907) 524-3299 |
| NPI Number | 1780614263 |
|---|---|
| Provider Enumeration Date | 07/03/2006 |
| Last Update Date | 09/15/2023 |
| Certification Date | 09/15/2023 |
| Medicare PECOS PAC ID | 5496663627 |
|---|---|
| Medicare Enrollment ID | O20051027000416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780614263 | NPI | - | NPPES |
| 1000855 | Medicaid | AK | |
| 1021095 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 20467 (Alaska) | Primary |
| Provider Name | Cindy D Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851346779 PECOS PAC ID: 4385662709 Enrollment ID: I20051103001173 |
| Provider Name | Aryeh L Levenson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245303650 PECOS PAC ID: 7214944461 Enrollment ID: I20060503000751 |
| Provider Name | June I Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396858114 PECOS PAC ID: 9032297304 Enrollment ID: I20080428000248 |
| Provider Name | John G Rosenfeld |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891726659 PECOS PAC ID: 9830258045 Enrollment ID: I20081103000495 |
| Provider Name | Daniel L Nagoda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649423948 PECOS PAC ID: 9234288549 Enrollment ID: I20090515000422 |
| Provider Name | Michael P Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790947349 PECOS PAC ID: 9234106501 Enrollment ID: I20090519000655 |
| Provider Name | Michelle A Tschida |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1790016293 PECOS PAC ID: 1759414634 Enrollment ID: I20101203000477 |
| Provider Name | Sarah M Dobbs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548510282 PECOS PAC ID: 4789833658 Enrollment ID: I20121009000724 |
| Provider Name | Amy K Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932442597 PECOS PAC ID: 9234379645 Enrollment ID: I20130709000095 |
| Provider Name | Christine Amy Hallas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538614722 PECOS PAC ID: 8820386469 Enrollment ID: I20161013001571 |
| Provider Name | Sean M Franey |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1750838843 PECOS PAC ID: 9335427350 Enrollment ID: I20161026001910 |
| Provider Name | Collin Thomas Atkinson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942754742 PECOS PAC ID: 0143508275 Enrollment ID: I20241105001605 |
| Provider Name | Elizabeth Linxwiler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043779838 PECOS PAC ID: 8820478175 Enrollment ID: I20241114000024 |