| Providence Health & Services Washington | |
|
413 Lilly Rd Ne Olympia WA 98506-5133 | |
| (360) 491-9480 | |
| Not Available |
| Full Name | Providence Health & Services Washington |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 413 Lilly Rd Ne, Olympia, Washington |
| Authorized Official Name and Position | Donald Wayne Anderson (DIRECTOR REIMBURSEMENT ADMINISTRATI) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Health & Services Washington Po Box 3505 Portland OR 97208-3505 Ph: () - | Providence Health & Services Washington 413 Lilly Rd Ne Olympia WA 98506-5133 Ph: (360) 491-9480 |
| NPI Number | 1619176997 |
|---|---|
| Provider Enumeration Date | 07/16/2007 |
| Last Update Date | 10/31/2017 |
| Medicare PECOS PAC ID | 7719873496 |
|---|---|
| Medicare Enrollment ID | O20040227000744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619176997 | NPI | - | NPPES |
| 9317108 | Medicaid | WA | |
| 8901337 | Other | WA | L&I CRIME VICTIMS |
| 129210 | Other | WA | L&I |
| Provider Name | Juliette K Erickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851489660 PECOS PAC ID: 4981590783 Enrollment ID: I20040227000154 |
| Provider Name | Eller C Manlapaz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932116076 PECOS PAC ID: 1052308087 Enrollment ID: I20040429001296 |
| Provider Name | George L Chappell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376633156 PECOS PAC ID: 0749279115 Enrollment ID: I20040511000059 |
| Provider Name | Ahmad Abadullah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225005721 PECOS PAC ID: 1052301306 Enrollment ID: I20040517001538 |
| Provider Name | Heidi J Bray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366492241 PECOS PAC ID: 8729065818 Enrollment ID: I20040707000270 |
| Provider Name | Vivek J Murari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487642591 PECOS PAC ID: 8123013489 Enrollment ID: I20040726000457 |
| Provider Name | Paul A Robertson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1639175938 PECOS PAC ID: 3274420575 Enrollment ID: I20041004000372 |
| Provider Name | Craig J Wehrli |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326049883 PECOS PAC ID: 1658332663 Enrollment ID: I20041022000862 |
| Provider Name | Ritawari Sharangpani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154473015 PECOS PAC ID: 8921069600 Enrollment ID: I20041026000253 |
| Provider Name | Anjan K Sattar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487754271 PECOS PAC ID: 0648228106 Enrollment ID: I20050111000691 |
| Provider Name | Jeffrey C Christenson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1932162872 PECOS PAC ID: 2062463110 Enrollment ID: I20050205000085 |
| Provider Name | Stephen D Lykins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194805390 PECOS PAC ID: 1456305754 Enrollment ID: I20050309000855 |
| Provider Name | Laurie T Sorenson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194871087 PECOS PAC ID: 8729019245 Enrollment ID: I20050825000181 |
| Provider Name | Alison J Spencer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215934054 PECOS PAC ID: 6608891965 Enrollment ID: I20051006000362 |
| Provider Name | Jimmy Z Swan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1447363734 PECOS PAC ID: 0446275473 Enrollment ID: I20051010000468 |
| Provider Name | Keith Schulze |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1174625693 PECOS PAC ID: 1759300635 Enrollment ID: I20051121000603 |
| Provider Name | Keith C Pasternak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477567725 PECOS PAC ID: 8123048410 Enrollment ID: I20051201000345 |
| Provider Name | John W Waggoner |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1922053016 PECOS PAC ID: 1850303579 Enrollment ID: I20060621000275 |
| Provider Name | Zhongzeng Li |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104865666 PECOS PAC ID: 0840228359 Enrollment ID: I20060710000093 |
| Provider Name | Darrel J Bell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669419594 PECOS PAC ID: 7911902408 Enrollment ID: I20060915000115 |
| Provider Name | Laurie A Mcgee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598777062 PECOS PAC ID: 8325044340 Enrollment ID: I20061016000325 |
| Provider Name | Mihai Florin Iancu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437263175 PECOS PAC ID: 5092712117 Enrollment ID: I20061103000124 |
| Provider Name | Michael R Ellen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1043287980 PECOS PAC ID: 4789685645 Enrollment ID: I20070122000078 |
| Provider Name | Jane M Geraci |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568560241 PECOS PAC ID: 4981606704 Enrollment ID: I20070207000715 |
| Provider Name | Qiang Li |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861446494 PECOS PAC ID: 7315041209 Enrollment ID: I20070403000046 |
| Provider Name | Kirk D Danielson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1093820797 PECOS PAC ID: 1658470067 Enrollment ID: I20070626000703 |
| Provider Name | Muhammad B Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770635930 PECOS PAC ID: 1759473275 Enrollment ID: I20070828000730 |
| Provider Name | Carie G Bussey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952486318 PECOS PAC ID: 5991898074 Enrollment ID: I20070905000657 |
| Provider Name | Eve Hyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720094592 PECOS PAC ID: 6002876216 Enrollment ID: I20070913000012 |
| Provider Name | Sharon Hinz |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1326109687 PECOS PAC ID: 2668566258 Enrollment ID: I20070913000059 |
| Provider Name | Rekha Chandran |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1457393878 PECOS PAC ID: 4688768872 Enrollment ID: I20070919000314 |
| Provider Name | Scott J Tibbits |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538220132 PECOS PAC ID: 8123108727 Enrollment ID: I20080109000114 |
| Provider Name | Sarah A Lux |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912069527 PECOS PAC ID: 3072693670 Enrollment ID: I20080109000152 |
| Provider Name | Sharon C Abegg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437291143 PECOS PAC ID: 7719069814 Enrollment ID: I20080129000183 |
| Provider Name | Lana K Bur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649449919 PECOS PAC ID: 1951349711 Enrollment ID: I20080312000181 |
| Provider Name | Zaher A Rafeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528176898 PECOS PAC ID: 5193701811 Enrollment ID: I20080624000242 |
| Provider Name | Andrzej T Himmel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174711634 PECOS PAC ID: 3779655261 Enrollment ID: I20080627000213 |
| Provider Name | Eve S Cunningham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477601409 PECOS PAC ID: 5193822336 Enrollment ID: I20080701000417 |
| Provider Name | Romil Wadhawan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417090044 PECOS PAC ID: 9931271814 Enrollment ID: I20080709000611 |
| Provider Name | Bridgit Bell |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1063525426 PECOS PAC ID: 2264482868 Enrollment ID: I20080916000665 |
| Provider Name | Alexander I Kats |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356533228 PECOS PAC ID: 4082709506 Enrollment ID: I20080926000172 |
| Provider Name | Scott Archer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093979940 PECOS PAC ID: 0941378954 Enrollment ID: I20081003000600 |
| Provider Name | Sarah Beardsley Merrifield |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1104014364 PECOS PAC ID: 4082691084 Enrollment ID: I20081008000817 |
| Provider Name | Maria Irina Ramneantu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336160373 PECOS PAC ID: 1355317678 Enrollment ID: I20090416000557 |
| Provider Name | Gregg K Vandekieft |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1922009885 PECOS PAC ID: 0749338333 Enrollment ID: I20090518000009 |
| Provider Name | Timothy S Larson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679782676 PECOS PAC ID: 1658421581 Enrollment ID: I20090615000329 |
| Provider Name | Scott Werden |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659554624 PECOS PAC ID: 0143255562 Enrollment ID: I20090615000362 |
| Provider Name | Hetal P Kothari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417190463 PECOS PAC ID: 1850442138 Enrollment ID: I20090626000124 |
| Provider Name | Richard C Redman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114192937 PECOS PAC ID: 9830242239 Enrollment ID: I20090803000394 |
| Provider Name | Yo Kondo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245428168 PECOS PAC ID: 0840344891 Enrollment ID: I20090811000225 |
| Provider Name | Rajendra K Suvarna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265434633 PECOS PAC ID: 8820039712 Enrollment ID: I20090811000515 |
| Provider Name | Bhabiswar Tiwari |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952553737 PECOS PAC ID: 3274687595 Enrollment ID: I20090820000268 |
| Provider Name | Katherine M Hogg |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1881657716 PECOS PAC ID: 6002954062 Enrollment ID: I20091111000430 |
| Provider Name | Elizabeth G Wheeler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588634778 PECOS PAC ID: 5092742429 Enrollment ID: I20091118000067 |
| Provider Name | Bonnie Virginia Baker |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1245341106 PECOS PAC ID: 5294876629 Enrollment ID: I20100107000672 |
| Provider Name | Brady Garland Miller |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1902915945 PECOS PAC ID: 0345381497 Enrollment ID: I20100111000835 |
| Provider Name | William P Brennan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487655858 PECOS PAC ID: 1456496223 Enrollment ID: I20100304000147 |
| Provider Name | Margo K Newell Eggert |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1710062740 PECOS PAC ID: 4385789197 Enrollment ID: I20100304000535 |
| Provider Name | Thomas W Hecht |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1609966118 PECOS PAC ID: 1052456688 Enrollment ID: I20100305000860 |
| Provider Name | Robert S Wark |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1730181769 PECOS PAC ID: 8820125388 Enrollment ID: I20100415000260 |
| Provider Name | Deborah A Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508941550 PECOS PAC ID: 4385771526 Enrollment ID: I20100420001066 |
| Provider Name | Jeri S Donahue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700102910 PECOS PAC ID: 1951438613 Enrollment ID: I20100429000014 |
| Provider Name | Corina G Rachita |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851377931 PECOS PAC ID: 4284764804 Enrollment ID: I20100608000881 |
| Provider Name | Mircea S Rachita |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710963178 PECOS PAC ID: 1759412042 Enrollment ID: I20100630000648 |
| Provider Name | Ronald Quinton |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1992756852 PECOS PAC ID: 5496642241 Enrollment ID: I20100727000501 |
| Provider Name | David Reed |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912945791 PECOS PAC ID: 0547394082 Enrollment ID: I20100818001294 |
| Provider Name | Leo W Kesting |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679531230 PECOS PAC ID: 1759440035 Enrollment ID: I20100907000486 |
| Provider Name | Robin G Ellingson-miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851313134 PECOS PAC ID: 5294850657 Enrollment ID: I20100909000333 |
| Provider Name | Jon C Kooiker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568420180 PECOS PAC ID: 8820157100 Enrollment ID: I20100909001026 |
| Provider Name | Thomas K Curry |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1811974652 PECOS PAC ID: 5698969988 Enrollment ID: I20101101000377 |
| Provider Name | Cristin Mount |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1477527125 PECOS PAC ID: 8426230491 Enrollment ID: I20110311000583 |
| Provider Name | Karen E Robinson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720014707 PECOS PAC ID: 4880798883 Enrollment ID: I20110428000447 |
| Provider Name | Robert J Williams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447353305 PECOS PAC ID: 6204004716 Enrollment ID: I20110727000218 |
| Provider Name | Mohammad H Yavarirad |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1285745554 PECOS PAC ID: 3173613379 Enrollment ID: I20111118000127 |
| Provider Name | Chuong H Nguyen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245340033 PECOS PAC ID: 6709970296 Enrollment ID: I20111203000182 |
| Provider Name | Marina Cheng |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1174720569 PECOS PAC ID: 0547417982 Enrollment ID: I20120820001192 |
| Provider Name | Margaret A Mullin |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1851534192 PECOS PAC ID: 2163670928 Enrollment ID: I20120919000845 |
| Provider Name | Saneer Basnett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508015173 PECOS PAC ID: 0941450209 Enrollment ID: I20121022000621 |
| Provider Name | Carlo Palarca |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265762678 PECOS PAC ID: 1951551332 Enrollment ID: I20121031000178 |
| Provider Name | George Paris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851533913 PECOS PAC ID: 3577730506 Enrollment ID: I20121031000221 |
| Provider Name | Dustin T Engelken |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174683007 PECOS PAC ID: 6305811423 Enrollment ID: I20121107000490 |
| Provider Name | Charles Frederick Rossow |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669797320 PECOS PAC ID: 0042458374 Enrollment ID: I20130529000064 |
| Provider Name | Walid Behnawa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689886921 PECOS PAC ID: 7214076009 Enrollment ID: I20130604000472 |
| Provider Name | Amy M. Arisco |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1821183856 PECOS PAC ID: 3577565589 Enrollment ID: I20131211001831 |
| Provider Name | Michael M Braun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598933012 PECOS PAC ID: 0840441820 Enrollment ID: I20140604002473 |
| Provider Name | Lauren W Fisher |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1215253778 PECOS PAC ID: 2567688583 Enrollment ID: I20140729001095 |
| Provider Name | Juan Miguel Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235469784 PECOS PAC ID: 4688813876 Enrollment ID: I20140818001186 |
| Provider Name | Judith C Presson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235264177 PECOS PAC ID: 5092934711 Enrollment ID: I20140911001246 |
| Provider Name | Mary E Fredericks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306188032 PECOS PAC ID: 3870817349 Enrollment ID: I20150112001030 |
| Provider Name | Joyce A Gilbert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174515993 PECOS PAC ID: 5193793347 Enrollment ID: I20150127001959 |
| Provider Name | Mu Qiao |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992947063 PECOS PAC ID: 5597912774 Enrollment ID: I20150219000479 |
| Provider Name | Joseph T Ho |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1487782009 PECOS PAC ID: 6709012404 Enrollment ID: I20150630003074 |
| Provider Name | Gopal Ghimire |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1811225923 PECOS PAC ID: 7719124577 Enrollment ID: I20150630003172 |
| Provider Name | Jean Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538559745 PECOS PAC ID: 8921314162 Enrollment ID: I20150902000965 |
| Provider Name | Matthew W Louie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952689077 PECOS PAC ID: 7214160118 Enrollment ID: I20150917001901 |
| Provider Name | Susan L Fraser |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1932187663 PECOS PAC ID: 0749477966 Enrollment ID: I20151023000038 |
| Provider Name | Erica M Dennehy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326296096 PECOS PAC ID: 9133439896 Enrollment ID: I20151109001188 |
| Provider Name | Kathryn M Burrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174854764 PECOS PAC ID: 0244540672 Enrollment ID: I20151113001695 |
| Provider Name | Susan Abraham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598926818 PECOS PAC ID: 5496926966 Enrollment ID: I20160516002053 |
| Provider Name | Monique Cherri Semien |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1013095660 PECOS PAC ID: 6507894607 Enrollment ID: I20160810000624 |
| Provider Name | Sara C Martinez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750543906 PECOS PAC ID: 4183853427 Enrollment ID: I20160824001309 |
| Provider Name | David Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740501865 PECOS PAC ID: 6608004601 Enrollment ID: I20160830001683 |
| Provider Name | Daniel G Cuadrado |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1154398006 PECOS PAC ID: 1759677198 Enrollment ID: I20160909002490 |
| Provider Name | Jesse Marcotte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780037648 PECOS PAC ID: 7911294780 Enrollment ID: I20160921002466 |
| Provider Name | Warangkhana Wongba |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1932314374 PECOS PAC ID: 2365607470 Enrollment ID: I20161021001580 |
| Provider Name | Heather Mcleod |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982792123 PECOS PAC ID: 8325328016 Enrollment ID: I20161215001587 |
| Provider Name | Gordon W Dowds |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1134115710 PECOS PAC ID: 4789747833 Enrollment ID: I20161228000734 |
| Provider Name | Aisha Choudhry |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1326334491 PECOS PAC ID: 2365677911 Enrollment ID: I20170111002459 |
| Provider Name | Tram Phuong Chu |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1043536949 PECOS PAC ID: 4385825470 Enrollment ID: I20170220002033 |
| Provider Name | Amber Piranio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821534801 PECOS PAC ID: 4486938644 Enrollment ID: I20170307001443 |
| Provider Name | Karen E Swift |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821159153 PECOS PAC ID: 5799768065 Enrollment ID: I20170602001789 |
| Provider Name | Chelsea Dawn Unruh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821402298 PECOS PAC ID: 3173749264 Enrollment ID: I20170728001739 |
| Provider Name | Corey White |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154610814 PECOS PAC ID: 2961723663 Enrollment ID: I20170811001881 |
| Provider Name | Anita J Chin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730110446 PECOS PAC ID: 3375547805 Enrollment ID: I20170815004043 |
| Provider Name | Raul Manuel Buenaflor Cruz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689843492 PECOS PAC ID: 3577637602 Enrollment ID: I20170821003088 |
| Provider Name | Sara Jane Wasilenko |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1528387941 PECOS PAC ID: 4082934633 Enrollment ID: I20170821003169 |
| Provider Name | Amanda N Clauson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1013432202 PECOS PAC ID: 6204100167 Enrollment ID: I20170916000431 |
| Provider Name | Puneet Bhullar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184910861 PECOS PAC ID: 2062712599 Enrollment ID: I20171002002746 |
| Provider Name | Rajit Kaushal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942432869 PECOS PAC ID: 9739338534 Enrollment ID: I20171109001295 |
| Provider Name | Shruti Kanwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932534419 PECOS PAC ID: 5991099111 Enrollment ID: I20171110000566 |
| Provider Name | Lisa B Neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407014749 PECOS PAC ID: 5698033538 Enrollment ID: I20171221002374 |
| Provider Name | Linda J Calderwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114300241 PECOS PAC ID: 2365758265 Enrollment ID: I20180124001685 |
| Provider Name | Mohammed Ali Al-awadhi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114366143 PECOS PAC ID: 5799087060 Enrollment ID: I20180621001671 |
| Provider Name | Jonathan Thomas Wingate |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1235405192 PECOS PAC ID: 9234351719 Enrollment ID: I20180702001498 |
| Provider Name | Rebecca Nowacki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942701669 PECOS PAC ID: 6204184856 Enrollment ID: I20180730003016 |
| Provider Name | Dominique Justin Pepper |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1750691713 PECOS PAC ID: 4183923311 Enrollment ID: I20180829002797 |
| Provider Name | Louise May |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1982961173 PECOS PAC ID: 7315184462 Enrollment ID: I20180905002456 |
| Provider Name | Patrick W Murray |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548606346 PECOS PAC ID: 0446492730 Enrollment ID: I20181002001595 |
| Provider Name | John O'boyle |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1306808381 PECOS PAC ID: 6901171636 Enrollment ID: I20181008001667 |
| Provider Name | Natalie S Angus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013396407 PECOS PAC ID: 5193023380 Enrollment ID: I20181030000936 |
| Provider Name | Jason M Reese |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750545893 PECOS PAC ID: 6002138385 Enrollment ID: I20181128001365 |
| Provider Name | Amy O'boyle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679548341 PECOS PAC ID: 9638447949 Enrollment ID: I20190104001737 |
| Provider Name | Jessica R Maike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841701752 PECOS PAC ID: 3779821079 Enrollment ID: I20190212002082 |
| Provider Name | Matheau Julien |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1619189933 PECOS PAC ID: 6002118254 Enrollment ID: I20190225000896 |
| Provider Name | Melissa Jo Gallardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578039749 PECOS PAC ID: 2062751142 Enrollment ID: I20190307001548 |
| Provider Name | Wai Lee |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1861752347 PECOS PAC ID: 4789931965 Enrollment ID: I20190318001188 |
| Provider Name | Frederick F Kash |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023070737 PECOS PAC ID: 4385680800 Enrollment ID: I20190716002851 |
| Provider Name | Trista Marie Newville |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528324712 PECOS PAC ID: 9830406461 Enrollment ID: I20190723003643 |
| Provider Name | Nathan L Jung |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1003229055 PECOS PAC ID: 9739305673 Enrollment ID: I20190821001571 |
| Provider Name | Michael M Goodblatt |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1952613374 PECOS PAC ID: 0749419240 Enrollment ID: I20190925000976 |
| Provider Name | Christina Klein |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1154731727 PECOS PAC ID: 4385995653 Enrollment ID: I20191108002932 |
| Provider Name | Hartaj Singh Girn |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033552237 PECOS PAC ID: 7810255353 Enrollment ID: I20191109000070 |
| Provider Name | Kristen N Pace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013435882 PECOS PAC ID: 6901238906 Enrollment ID: I20191113000739 |
| Provider Name | Madeline Nguyen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083058275 PECOS PAC ID: 8123398203 Enrollment ID: I20191113002398 |
| Provider Name | Victor De Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497234884 PECOS PAC ID: 2860824216 Enrollment ID: I20191122002737 |
| Provider Name | Sheila Steinbrenner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124672126 PECOS PAC ID: 5698109965 Enrollment ID: I20191218002948 |
| Provider Name | Marc Bouchard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750677605 PECOS PAC ID: 3870724867 Enrollment ID: I20200108000813 |
| Provider Name | Gregory R Skerrett |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1407055569 PECOS PAC ID: 2264651587 Enrollment ID: I20200213000725 |
| Provider Name | Jasjit Khurana |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801039151 PECOS PAC ID: 0042481525 Enrollment ID: I20200312001857 |
| Provider Name | Stephen L Noble |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1861697278 PECOS PAC ID: 2264669225 Enrollment ID: I20200518000556 |
| Provider Name | Natasza M Posielski |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1477940518 PECOS PAC ID: 0749590610 Enrollment ID: I20200629000899 |
| Provider Name | Haroon Yousaf |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1871731364 PECOS PAC ID: 2769514611 Enrollment ID: I20200909003117 |
| Provider Name | Dwight E Hand |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1780766238 PECOS PAC ID: 4385742998 Enrollment ID: I20200910002200 |
| Provider Name | Tess K Shepherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558829879 PECOS PAC ID: 4688093560 Enrollment ID: I20200925001140 |
| Provider Name | Jatinder Banipal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609300029 PECOS PAC ID: 1658644901 Enrollment ID: I20201002001149 |
| Provider Name | Rubina Dhaliwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831623859 PECOS PAC ID: 3274899968 Enrollment ID: I20201130000293 |
| Provider Name | Christopher Tarney |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1528303336 PECOS PAC ID: 1052604303 Enrollment ID: I20210119001281 |
| Provider Name | Mordechai Groner |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1427347764 PECOS PAC ID: 0547545204 Enrollment ID: I20210525002578 |
| Provider Name | Michael Switzer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1215290192 PECOS PAC ID: 4486962800 Enrollment ID: I20210622002960 |
| Provider Name | Valeria Petkova Ilieva |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1184962680 PECOS PAC ID: 4688076607 Enrollment ID: I20210714000949 |
| Provider Name | Katie E Kunnen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487912069 PECOS PAC ID: 7214237346 Enrollment ID: I20210730001604 |
| Provider Name | Mohammed Al Qaraghouli |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134650138 PECOS PAC ID: 5395084040 Enrollment ID: I20210806001147 |
| Provider Name | Marissa Braun |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548617251 PECOS PAC ID: 0244634574 Enrollment ID: I20210810000291 |
| Provider Name | Jennifer M Abelson |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1497989057 PECOS PAC ID: 1557615416 Enrollment ID: I20210817004224 |
| Provider Name | Kristyn Kalei Criss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487229654 PECOS PAC ID: 6608272273 Enrollment ID: I20210907001983 |
| Provider Name | Regina Maria N San Pedro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548793649 PECOS PAC ID: 0143626697 Enrollment ID: I20210908002139 |
| Provider Name | Nels D Carroll |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1396122099 PECOS PAC ID: 9638462344 Enrollment ID: I20210920003145 |
| Provider Name | Kamal R Joshi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508020801 PECOS PAC ID: 5597082859 Enrollment ID: I20210924001070 |
| Provider Name | Jeremy Paul D Santiago |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841647104 PECOS PAC ID: 6608166269 Enrollment ID: I20211028001206 |
| Provider Name | Anish S Konde |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1417343971 PECOS PAC ID: 0648560631 Enrollment ID: I20211028002584 |
| Provider Name | Suchit Khanijao |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1942635412 PECOS PAC ID: 1456646371 Enrollment ID: I20211112000689 |
| Provider Name | Katie E Wodaege |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1194498345 PECOS PAC ID: 4981093903 Enrollment ID: I20211112002526 |
| Provider Name | Khaled Darwesh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265963805 PECOS PAC ID: 0941573745 Enrollment ID: I20220307002221 |
| Provider Name | Robert M Ore |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1326213794 PECOS PAC ID: 7911144100 Enrollment ID: I20220504000480 |
| Provider Name | Scott C Steinbach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427060664 PECOS PAC ID: 1052311883 Enrollment ID: I20220804001304 |
| Provider Name | Tamara Eklund |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679107239 PECOS PAC ID: 9739562760 Enrollment ID: I20220823004023 |
| Provider Name | Mijung Lee |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1093970048 PECOS PAC ID: 5991921751 Enrollment ID: I20220826002199 |
| Provider Name | Brandon Haynes |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679872238 PECOS PAC ID: 8527375641 Enrollment ID: I20220907002418 |
| Provider Name | Shayna Nitin Mooney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164982245 PECOS PAC ID: 9739414848 Enrollment ID: I20220927002629 |
| Provider Name | Kate A Slaymaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538622907 PECOS PAC ID: 1052797123 Enrollment ID: I20220928000497 |
| Provider Name | Caleb Hunter Schlauderaff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932601168 PECOS PAC ID: 3678807518 Enrollment ID: I20220930000410 |
| Provider Name | David W Nesheim |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1205253481 PECOS PAC ID: 2062843535 Enrollment ID: I20221109003483 |
| Provider Name | Raymond D Fisher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245640515 PECOS PAC ID: 0749577450 Enrollment ID: I20221128000784 |
| Provider Name | Pierre Mechali |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528357274 PECOS PAC ID: 4688844525 Enrollment ID: I20230112001663 |
| Provider Name | Jennifer Lynn Curtis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386237931 PECOS PAC ID: 6800205014 Enrollment ID: I20230125000531 |
| Provider Name | Shravani R Nalla |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699180521 PECOS PAC ID: 1456577196 Enrollment ID: I20230217001520 |
| Provider Name | Tiffany M Heiges |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1942860291 PECOS PAC ID: 2769855881 Enrollment ID: I20230310000134 |
| Provider Name | Sundar Cherukuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427511849 PECOS PAC ID: 2769865815 Enrollment ID: I20230808002988 |
| Provider Name | Jessica L Poteet |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598102808 PECOS PAC ID: 2860763760 Enrollment ID: I20230926003285 |
| Provider Name | Stanley C Clark |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1770591620 PECOS PAC ID: 0749280121 Enrollment ID: I20230927002388 |
| Provider Name | Kawandus L Bennett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912945718 PECOS PAC ID: 4688682115 Enrollment ID: I20231005001994 |
| Provider Name | Christopher Iwanoff |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174817118 PECOS PAC ID: 7517398647 Enrollment ID: I20231006002971 |
| Provider Name | Daniel Kissau |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861996837 PECOS PAC ID: 8224384300 Enrollment ID: I20231011000583 |
| Provider Name | Peter E Jorgenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376156216 PECOS PAC ID: 0648625186 Enrollment ID: I20231018001910 |
| Provider Name | Jairo Enrigue Mendoza Briceno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982227062 PECOS PAC ID: 7618365156 Enrollment ID: I20231031001771 |
| Provider Name | Kristin R Duenow |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962498865 PECOS PAC ID: 4486097987 Enrollment ID: I20240212004279 |
| Provider Name | Ladonna Putman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083147599 PECOS PAC ID: 6406299866 Enrollment ID: I20240213002180 |
| Provider Name | Allan Young |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1659514321 PECOS PAC ID: 8426338872 Enrollment ID: I20240222001172 |
| Provider Name | Anand Pullapilly |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1457647729 PECOS PAC ID: 6507080496 Enrollment ID: I20240223002547 |
| Provider Name | Tui Fern Lindsey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750850566 PECOS PAC ID: 9739524760 Enrollment ID: I20240229003505 |
| Provider Name | Rebecca L Broderick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629755657 PECOS PAC ID: 0244676575 Enrollment ID: I20240308003642 |
Attuned Family Therapy Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2222 State Ave Ne Ste B, Olympia, WA 98506 Phone: 360-556-6374 Fax: 360-359-7161 | |
Molly Henderson Arnp Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1005 Olympia Ave Ne, Olympia, WA 98506 Phone: 360-791-5933 | |
Meaningful Life Psychology Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2024 Caton Way Sw Ste 102, Olympia, WA 98502 Phone: 619-284-2535 | |
Oversight Telemedicine Physicians -texas, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9333 Martin Way E, Ste 214, Olympia, WA 98516 Phone: 360-539-8487 Fax: 360-358-9944 | |
Behavioral Health Resources Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3857 Martin Way E, Olympia, WA 98506 Phone: 360-704-7170 Fax: 360-709-4374 | |
Providence Community Care Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 225 State Ave Ne, Olympia, WA 98501 Phone: 360-486-6400 | |
Finnell Townsend Therapy Partners Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 4th Ave E Ste 309, Olympia, WA 98501 Phone: 206-552-0377 |