Rippl Care Pc Of New Jersey, Pc | |
2825 Eastlake Ave E Ste 230 Seattle WA 98102-3013 | |
(206) 647-1007 | |
Not Available |
Full Name | Rippl Care Pc Of New Jersey, Pc |
---|---|
Speciality | Nurse Practitioner |
Location | 2825 Eastlake Ave E Ste 230, Seattle, Washington |
Authorized Official Name and Position | Jason Van Reken (TREASURER) |
Authorized Official Contact | 2066471007 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Rippl Care Pc Of New Jersey, Pc Po Box 352 Mercer Island WA 98040-0352 Ph: (206) 647-1007 | Rippl Care Pc Of New Jersey, Pc 2825 Eastlake Ave E Ste 230 Seattle WA 98102-3013 Ph: (206) 647-1007 |
NPI Number | 1033970025 |
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Provider Enumeration Date | 01/17/2024 |
Last Update Date | 03/04/2024 |
Certification Date | 03/04/2024 |
Medicare PECOS PAC ID | 1355783796 |
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Medicare Enrollment ID | O20240530001648 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033970025 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Provider Name | William Blackwell |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1215162078 PECOS PAC ID: 6800050774 Enrollment ID: I20240530001778 |
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