| Rainier Springs Physician Group, Llc | |
|
2805 Ne 129th Street Vancouver WA 98686 | |
| (360) 356-1890 | |
| (360) 356-1891 |
| Full Name | Rainier Springs Physician Group, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2805 Ne 129th Street, Vancouver, Washington |
| Authorized Official Name and Position | Greg Miller (EVP, CFO) |
| Authorized Official Contact | 4125883546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rainier Springs Physician Group, Llc 101 S 5th St Louisville KY 40202-3157 Ph: (360) 356-1890 | Rainier Springs Physician Group, Llc 2805 Ne 129th Street Vancouver WA 98686 Ph: (360) 356-1890 |
| NPI Number | 1306321237 |
|---|---|
| Provider Enumeration Date | 09/26/2018 |
| Last Update Date | 05/20/2020 |
| Certification Date | 05/20/2020 |
| Medicare PECOS PAC ID | 0547514549 |
|---|---|
| Medicare Enrollment ID | O20181109001590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306321237 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | Patricia J Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811967508 PECOS PAC ID: 7911800875 Enrollment ID: I20040128000983 |
| Provider Name | Samir Aziz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588730287 PECOS PAC ID: 5799740775 Enrollment ID: I20051117000893 |
| Provider Name | Jennifer Clingenpeel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992886956 PECOS PAC ID: 4486678547 Enrollment ID: I20060117000690 |
| Provider Name | Daniel D Varnell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649240532 PECOS PAC ID: 7012801723 Enrollment ID: I20061207000295 |
| Provider Name | Gilbert Simas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497802383 PECOS PAC ID: 3274684071 Enrollment ID: I20090707000365 |
| Provider Name | Celia G Forno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437293909 PECOS PAC ID: 4183630080 Enrollment ID: I20100924000582 |
| Provider Name | Elia R Gonzalez-rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609979558 PECOS PAC ID: 9537214374 Enrollment ID: I20110915000842 |
| Provider Name | Mary A Nametka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104835297 PECOS PAC ID: 2567557382 Enrollment ID: I20120313000472 |
| Provider Name | Marco V Baquero |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730298902 PECOS PAC ID: 4183512007 Enrollment ID: I20140701000580 |
| Provider Name | Cheryl M Mercurio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588085443 PECOS PAC ID: 5799095519 Enrollment ID: I20151106002216 |
| Provider Name | Brent A. Crane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336469287 PECOS PAC ID: 9739336058 Enrollment ID: I20160707002565 |
| Provider Name | Salman Kazim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154437457 PECOS PAC ID: 1153410360 Enrollment ID: I20170509002772 |
| Provider Name | Rina Myklak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578954657 PECOS PAC ID: 5991024010 Enrollment ID: I20171025001096 |
| Provider Name | Daniel E Roa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801266119 PECOS PAC ID: 1951665918 Enrollment ID: I20180808000336 |
| Provider Name | Edward G Worsman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477987386 PECOS PAC ID: 3870842685 Enrollment ID: I20180827002990 |
| Provider Name | Jeffrey Robert Gruhler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639445752 PECOS PAC ID: 5294960019 Enrollment ID: I20181212002510 |
| Provider Name | Nadine A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205082062 PECOS PAC ID: 5294976106 Enrollment ID: I20190222002011 |
| Provider Name | Xixi Wong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174815997 PECOS PAC ID: 0648560607 Enrollment ID: I20190314001640 |
| Provider Name | Lindsay Marie Mcginnis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144699224 PECOS PAC ID: 1052629102 Enrollment ID: I20190529003285 |
| Provider Name | Joanna Wade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023482627 PECOS PAC ID: 3173826013 Enrollment ID: I20190617003206 |
| Provider Name | Renee A Bacas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295952497 PECOS PAC ID: 1951578103 Enrollment ID: I20190715000745 |
| Provider Name | Kenneth Richmond |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184891277 PECOS PAC ID: 6608015342 Enrollment ID: I20190715001697 |
| Provider Name | Monika Karazja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801206578 PECOS PAC ID: 1759656960 Enrollment ID: I20190722000134 |
| Provider Name | Michael M Messer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689740821 PECOS PAC ID: 5698673614 Enrollment ID: I20191003001597 |
| Provider Name | Vandana N Bindal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639113590 PECOS PAC ID: 9133121635 Enrollment ID: I20191114001281 |
| Provider Name | Deborah Lee Cline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518433721 PECOS PAC ID: 6406281534 Enrollment ID: I20200120001066 |
| Provider Name | Peri Anne Mayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942790035 PECOS PAC ID: 1759718984 Enrollment ID: I20200227000911 |
| Provider Name | Audrey Cavins-ezell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154899805 PECOS PAC ID: 3971848839 Enrollment ID: I20200303002665 |
| Provider Name | Zane A Curtis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023465234 PECOS PAC ID: 8820383334 Enrollment ID: I20200504002196 |
| Provider Name | Darcy K Trenkle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114217619 PECOS PAC ID: 9638484769 Enrollment ID: I20200820003359 |
| Provider Name | Fidel Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104461961 PECOS PAC ID: 2264858141 Enrollment ID: I20200824000647 |
| Provider Name | Emilia Bazan-grow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902835275 PECOS PAC ID: 4183621311 Enrollment ID: I20200911002649 |
| Provider Name | Lauren Welner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902325442 PECOS PAC ID: 3072870203 Enrollment ID: I20201113002244 |
| Provider Name | Sarah Schrauben |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851525620 PECOS PAC ID: 0648581223 Enrollment ID: I20201125001263 |
| Provider Name | Shirley E Mohren-graves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568461465 PECOS PAC ID: 7012902810 Enrollment ID: I20210324002377 |
| Provider Name | Julie M Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801202528 PECOS PAC ID: 0749402642 Enrollment ID: I20210723001372 |
| Provider Name | Brian Holoyda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144588989 PECOS PAC ID: 6305118910 Enrollment ID: I20210820002942 |
| Provider Name | Ikechi Alex Ikechi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083221006 PECOS PAC ID: 5193132900 Enrollment ID: I20210927002785 |
| Provider Name | Jessica Estes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487632709 PECOS PAC ID: 7113959867 Enrollment ID: I20211022002204 |
| Provider Name | Charles Jin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801966924 PECOS PAC ID: 1658329693 Enrollment ID: I20220204000328 |
| Provider Name | Matthew T Boire |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235449463 PECOS PAC ID: 3971749276 Enrollment ID: I20220401000512 |
| Provider Name | Todd Palumbo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073629010 PECOS PAC ID: 6709977838 Enrollment ID: I20220919003353 |
| Provider Name | Robert P Boyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346557550 PECOS PAC ID: 4789086513 Enrollment ID: I20221130002344 |
| Provider Name | Peggy M Gironde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043911738 PECOS PAC ID: 2365803137 Enrollment ID: I20230727000848 |
| Provider Name | Robert James Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629421664 PECOS PAC ID: 4587066295 Enrollment ID: I20240529001087 |
Fletcher Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Ne Park Plaza Dr, Suite 292, Vancouver, WA 98684 Phone: 360-524-5879 Fax: 360-326-1834 | |
Daybreak Vancouver Outpatient Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11818 Se Mill Plain Blvd, Suite 307, Vancouver, WA 98684 Phone: 360-750-9635 Fax: 360-334-9541 | |
Sleep Health Clinic Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2501 Ne 134th St Ste 203, Vancouver, WA 98686 Phone: -- | |
Awaken Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4602 Ne 59th Ave, Vancouver, WA 98661 Phone: 503-410-3048 | |
Vancover Treatment Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2009 Ne 117th Street, Ste. 101, Vancouver, WA 98686 Phone: 360-566-9112 Fax: 360-566-9133 | |
Moontree Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3305 Main St Ste 23, Vancouver, WA 98663 Phone: 360-949-2727 | |
Dale B Mortimer Md Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10000 Ne 7th Ave, Suite 385, Vancouver, WA 98685 Phone: 360-882-9058 Fax: 360-567-0861 |