| South Puget Sound Neurology, Pllc | |
|
5006 Center Street Suite U Tacoma WA 98409-2314 | |
| (253) 284-4488 | |
| (253) 272-4771 |
| Full Name | South Puget Sound Neurology, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5006 Center Street, Tacoma, Washington |
| Authorized Official Name and Position | Patrick J Hogan Iii (PRESIDENT/PHYSICIAN) |
| Authorized Official Contact | 2532844488 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Puget Sound Neurology, Pllc 5006 Center Street Suite U Tacoma WA 98409-2314 Ph: (253) 284-4488 | South Puget Sound Neurology, Pllc 5006 Center Street Suite U Tacoma WA 98409-2314 Ph: (253) 284-4488 |
| NPI Number | 1194052357 |
|---|---|
| Provider Enumeration Date | 11/09/2009 |
| Last Update Date | 04/19/2023 |
| Certification Date | 04/19/2023 |
| Medicare PECOS PAC ID | 4486789427 |
|---|---|
| Medicare Enrollment ID | O20100316001018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194052357 | NPI | - | NPPES |
| G8801180 | Medicaid | WA |
| Provider Name | Sharon Jung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699770628 PECOS PAC ID: 5799770244 Enrollment ID: I20040415000800 |
| Provider Name | Patrick J Hogan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245237734 PECOS PAC ID: 0345233169 Enrollment ID: I20040415001059 |
| Provider Name | Joan B Hogan |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1982840450 PECOS PAC ID: 5991986937 Enrollment ID: I20110223000594 |
| Provider Name | Leslie S Casias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699085308 PECOS PAC ID: 5698918951 Enrollment ID: I20150529002664 |
| Provider Name | Megan G Wildes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235660929 PECOS PAC ID: 3173809670 Enrollment ID: I20170418001735 |
| Provider Name | So Hee Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679001846 PECOS PAC ID: 8628347051 Enrollment ID: I20170628002173 |
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