| One Heart Wild | |
|
12620 Willamette Meridian Rd Nw Silverdale WA 98383-9701 | |
| (360) 509-2948 | |
| (360) 337-7433 |
| Full Name | One Heart Wild |
|---|---|
| Speciality | Social Worker |
| Location | 12620 Willamette Meridian Rd Nw, Silverdale, Washington |
| Authorized Official Name and Position | Brenda Lee Newell (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4252806508 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| One Heart Wild 12620 Willamette Meridian Rd Nw Silverdale WA 98383-9701 Ph: (360) 509-2948 | One Heart Wild 12620 Willamette Meridian Rd Nw Silverdale WA 98383-9701 Ph: (360) 509-2948 |
| NPI Number | 1548750615 |
|---|---|
| Provider Enumeration Date | 05/15/2018 |
| Last Update Date | 11/03/2023 |
| Certification Date | 11/03/2023 |
| Medicare PECOS PAC ID | 8921444290 |
|---|---|
| Medicare Enrollment ID | O20240308001173 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548750615 | NPI | - | NPPES |
| 2083710 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LICSW (Washington) | Primary |
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