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2825 Eastlake Ave E Ste 115 Seattle WA 98102-3084 | |
(206) 795-0697 | |
(844) 668-4622 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2825 Eastlake Ave E Ste 115, Seattle, Washington |
Authorized Official Name and Position | Sunil K Aggarwal (MBR) |
Authorized Official Contact | 2064201321 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2825 Eastlake Ave E Ste 115 Seattle WA 98102-3084 Ph: (206) 420-1321 | 2825 Eastlake Ave E Ste 115 Seattle WA 98102-3084 Ph: (206) 795-0697 |
NPI Number | 1699253112 |
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Provider Enumeration Date | 08/06/2018 |
Last Update Date | 04/01/2020 |
Medicare PECOS PAC ID | 6002155595 |
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Medicare Enrollment ID | O20190227002358 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699253112 | NPI | - | NPPES |
2105521 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Lisa R Yeager |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1689704520 PECOS PAC ID: 3870690126 Enrollment ID: I20070521000435 |
Provider Name | Sunil K Aggarwal |
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Provider Type | Practitioner - Hospice/palliative Care |
Provider Identifiers | NPI Number: 1114244324 PECOS PAC ID: 2668781717 Enrollment ID: I20151012002420 |
Provider Name | Therry Rose J Eparwa |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578702700 PECOS PAC ID: 5395895601 Enrollment ID: I20160203001697 |
Provider Name | Lindsey Youngquist |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235661216 PECOS PAC ID: 7911276985 Enrollment ID: I20200521002633 |
Provider Name | Gina Bridgette Perez Baron |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275703118 PECOS PAC ID: 3476699794 Enrollment ID: I20201029000443 |
Provider Name | Jasleena K Grewal |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982177168 PECOS PAC ID: 2567877657 Enrollment ID: I20210223002787 |
Provider Name | Moira Opalka |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316015381 PECOS PAC ID: 7911936943 Enrollment ID: I20210915000401 |
Provider Name | Alison Beth Draisin |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1568631414 PECOS PAC ID: 4880035955 Enrollment ID: I20240508000003 |
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