| Suquamish Wellness Center | |
|
18490 Suquamish Way Ne Unit 107 Suquamish WA 98392-9533 | |
| (360) 394-8558 | |
| (360) 598-1724 |
| Full Name | Suquamish Wellness Center |
|---|---|
| Speciality | Counselor |
| Location | 18490 Suquamish Way Ne Unit 107, Suquamish, Washington |
| Authorized Official Name and Position | Stephen Henry Kutz (HEALTH CLINIC DIRECTOR) |
| Authorized Official Contact | 3603948552 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suquamish Wellness Center Po Box 1228 Suquamish WA 98392-1228 Ph: (360) 394-5200 | Suquamish Wellness Center 18490 Suquamish Way Ne Unit 107 Suquamish WA 98392-9533 Ph: (360) 394-8558 |
| NPI Number | 1083747216 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 02/02/2024 |
| Certification Date | 02/02/2024 |
| Medicare PECOS PAC ID | 3173975893 |
|---|---|
| Medicare Enrollment ID | O20240216001062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083747216 | NPI | - | NPPES |
| Provider Name | Kristine Ewing |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972589422 PECOS PAC ID: 2769661396 Enrollment ID: I20240124002049 |
| Provider Name | Terry Basolo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336527027 PECOS PAC ID: 3274977673 Enrollment ID: I20240213003865 |
| Provider Name | Lisa Pratt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851733729 PECOS PAC ID: 4688818867 Enrollment ID: I20240214002920 |
| Provider Name | Susannah Margaret Hart Stephens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639558885 PECOS PAC ID: 6305280413 Enrollment ID: I20240216001749 |
| Provider Name | Casey Kernan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861982944 PECOS PAC ID: 2769727296 Enrollment ID: I20240326000561 |
| Provider Name | Tomas M Axtelle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568505253 PECOS PAC ID: 3678911666 Enrollment ID: I20240410001242 |
| Provider Name | Johnny Valentine Ravenwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053903724 PECOS PAC ID: 0941640411 Enrollment ID: I20240501000743 |
| Provider Name | Brian Graham Burwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477821171 PECOS PAC ID: 5799126819 Enrollment ID: I20240507002992 |
Michael Boltwood , Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6000 Whale Dancer Ct Ne, Suquamish, WA 98392 Phone: 360-698-1321 Fax: 360-308-0447 |