| Noble Physicians | |
|
21709 113th St E Bonney Lake WA 98391-7844 | |
| (253) 737-5764 | |
| (253) 220-2127 |
| Full Name | Noble Physicians |
|---|---|
| Speciality | Internal Medicine |
| Location | 21709 113th St E, Bonney Lake, Washington |
| Authorized Official Name and Position | Steven Miles Rudnick (OWNER) |
| Authorized Official Contact | 2537375764 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Noble Physicians 6300 Sand Point Way Ne Suite 210 Seattle WA 98115-7972 Ph: (253) 737-5764 | Noble Physicians 21709 113th St E Bonney Lake WA 98391-7844 Ph: (253) 737-5764 |
| NPI Number | 1568729572 |
|---|---|
| Provider Enumeration Date | 04/15/2012 |
| Last Update Date | 06/13/2022 |
| Medicare PECOS PAC ID | 2365606340 |
|---|---|
| Medicare Enrollment ID | O20120605000183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568729572 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD00043225 (Washington) | Primary |
| Provider Name | Steven M Rudnick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689735102 PECOS PAC ID: 9234125931 Enrollment ID: I20040420001346 |
| Provider Name | Lisa A Pujol Boe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548343122 PECOS PAC ID: 7517986532 Enrollment ID: I20130801000796 |
| Provider Name | Victoria M Mead |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689802266 PECOS PAC ID: 0042467953 Enrollment ID: I20131106000254 |
| Provider Name | Will W Leighty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811285026 PECOS PAC ID: 9234354366 Enrollment ID: I20140724000585 |
| Provider Name | Holly Amber Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922526607 PECOS PAC ID: 4385902691 Enrollment ID: I20171214001074 |
| Provider Name | Sylvie A Hakizimana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568980761 PECOS PAC ID: 3274892823 Enrollment ID: I20180105001367 |
| Provider Name | Deanna L Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801291935 PECOS PAC ID: 3375855760 Enrollment ID: I20190222002545 |
| Provider Name | Candis Leshawn Halsted |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255005898 PECOS PAC ID: 5698163699 Enrollment ID: I20211025001472 |
| Provider Name | Haddy Mbye-saho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417506312 PECOS PAC ID: 9739567199 Enrollment ID: I20220527000725 |
| Provider Name | Jalyn Benca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659053254 PECOS PAC ID: 2163876269 Enrollment ID: I20230922002514 |
| Provider Name | Megan Lister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346014479 PECOS PAC ID: 0345685368 Enrollment ID: I20240229003225 |
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