| |
100 N Tribal Center Rd Skokomish Nation WA 98584-9748 | |
(360) 426-5755 | |
(360) 877-2032 |
Full Name | |
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Speciality | Family Medicine |
Location | 100 N Tribal Center Rd, Skokomish Nation, Washington |
Authorized Official Name and Position | Frances L Longshore (BUSINESS OFFICE MANAGER) |
Authorized Official Contact | 3604265755 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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100 N Tribal Center Rd Skokomish Nation WA 98584-9748 Ph: (360) 426-5755 | 100 N Tribal Center Rd Skokomish Nation WA 98584-9748 Ph: (360) 426-5755 |
NPI Number | 1316056096 |
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Provider Enumeration Date | 08/29/2006 |
Last Update Date | 02/08/2012 |
Medicare PECOS PAC ID | 7719060375 |
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Medicare Enrollment ID | O20080206000263 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316056096 | NPI | - | NPPES |
2000539 | Medicaid | WA | |
1980796 | Medicaid | WA | |
1981067 | Medicaid | WA | |
7057508 | Medicaid | WA | |
1044601 | Medicaid | WA | |
7133473 | Medicaid | WA | |
1007457 | Medicaid | WA | |
5400072 | Medicaid | WA | |
7048267 | Medicaid | WA | |
2031961 | Medicaid | WA | |
1042775 | Medicaid | WA | |
1991512 | Medicaid | WA | |
5021258 | Medicaid | WA |
Provider Name | Deborah Behre |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1790994820 PECOS PAC ID: 3779509773 Enrollment ID: I20120224000054 |
Provider Name | Kateryna Sergiyivna Ivanova |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1699066373 PECOS PAC ID: 5294964318 Enrollment ID: I20150820010633 |
Provider Name | Josef Scott |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1972546919 PECOS PAC ID: 5890797971 Enrollment ID: I20171102002176 |
Provider Name | Darren Cuevas |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023497310 PECOS PAC ID: 2961707393 Enrollment ID: I20240926000854 |