| Cascade Nurse Practitioners | |
|
5409 100th St Sw Unit 39800 Lakewood WA 98496-0970 | |
| (253) 549-8576 | |
| (877) 682-9319 |
| Full Name | Cascade Nurse Practitioners |
|---|---|
| Speciality | Family Medicine |
| Location | 5409 100th St Sw Unit 39800, Lakewood, Washington |
| Authorized Official Name and Position | Rhonda R Otte (CREDENTIALING/CONTRACTING MANAGER) |
| Authorized Official Contact | 2063872469 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cascade Nurse Practitioners 5409 100th St Sw Unit 39800 Lakewood WA 98496-0970 Ph: (253) 576-8832 | Cascade Nurse Practitioners 5409 100th St Sw Unit 39800 Lakewood WA 98496-0970 Ph: (253) 549-8576 |
| NPI Number | 1922635887 |
|---|---|
| Provider Enumeration Date | 03/23/2020 |
| Last Update Date | 06/29/2020 |
| Medicare PECOS PAC ID | 8820410848 |
|---|---|
| Medicare Enrollment ID | O20200622000709 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922635887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Arlene Maria Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982875035 PECOS PAC ID: 8921291121 Enrollment ID: I20101020000815 |
| Provider Name | Locky N Kamau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881022689 PECOS PAC ID: 3375770126 Enrollment ID: I20131226000717 |
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