| Cnchc Sanpoil Valley Community Health Center | |
|
39 Shortcut Road Inchelium WA 99138 | |
| (509) 722-7006 | |
| (509) 722-3652 |
| Full Name | Cnchc Sanpoil Valley Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 39 Shortcut Road, Inchelium, Washington |
| Authorized Official Name and Position | Tom Sargent (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5097227637 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cnchc Sanpoil Valley Community Health Center Po Box 290 Inchelium WA 99138-0290 Ph: (509) 722-7006 | Cnchc Sanpoil Valley Community Health Center 39 Shortcut Road Inchelium WA 99138 Ph: (509) 722-7006 |
| NPI Number | 1043335961 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 01/05/2023 |
| Medicare PECOS PAC ID | 8820363716 |
|---|---|
| Medicare Enrollment ID | O20180208001598 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043335961 | NPI | - | NPPES |
| 2085257 | Medicaid | WA | |
| 2085258 | Medicaid | WA | |
| 2085645 | Medicaid | WA |
| Provider Name | Robin Kenning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700215225 PECOS PAC ID: 8628290814 Enrollment ID: I20151021000941 |
| Provider Name | H Theresa Porter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679612766 PECOS PAC ID: 1052557170 Enrollment ID: I20180313000246 |
| Provider Name | Lorrie Dawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245248384 PECOS PAC ID: 1153478896 Enrollment ID: I20180316000086 |
| Provider Name | Kimberlyn A Johnstone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528128907 PECOS PAC ID: 7618051327 Enrollment ID: I20180316000443 |
| Provider Name | Robin N Moyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821158734 PECOS PAC ID: 9739260720 Enrollment ID: I20180319000236 |
| Provider Name | Dru Rodriguez |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1144262247 PECOS PAC ID: 9931222437 Enrollment ID: I20180319000709 |
| Provider Name | Thomas A Thorn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942248109 PECOS PAC ID: 5890781355 Enrollment ID: I20180320000277 |
| Provider Name | Mark A Hoover |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154361335 PECOS PAC ID: 6305759168 Enrollment ID: I20180329000696 |
| Provider Name | Tammy E Lewis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558522169 PECOS PAC ID: 4082686407 Enrollment ID: I20180504000024 |
| Provider Name | Maria T Trevino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528174372 PECOS PAC ID: 8224058938 Enrollment ID: I20180525000612 |
| Provider Name | Forrest G Mcgriff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538147764 PECOS PAC ID: 0446247761 Enrollment ID: I20190220002875 |
| Provider Name | David M Colvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629544457 PECOS PAC ID: 7012258411 Enrollment ID: I20190412000412 |
| Provider Name | Steven D Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457331605 PECOS PAC ID: 5395753776 Enrollment ID: I20190722000487 |
| Provider Name | Angela L Mcclain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427612597 PECOS PAC ID: 2668702408 Enrollment ID: I20190923000366 |
| Provider Name | Nessamarie E Bates |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477114650 PECOS PAC ID: 1850726530 Enrollment ID: I20200128000462 |
| Provider Name | Thomas F Lilly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578188165 PECOS PAC ID: 0446676043 Enrollment ID: I20200806000200 |
| Provider Name | Gil I Javelosa |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891075560 PECOS PAC ID: 8426321027 Enrollment ID: I20230302001388 |
| Provider Name | Sara A Martin-washo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679973937 PECOS PAC ID: 5092188508 Enrollment ID: I20230324000842 |
| Provider Name | Susan Solomon Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447956479 PECOS PAC ID: 4981060019 Enrollment ID: I20230516002534 |
| Provider Name | Alexander Burns |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881056620 PECOS PAC ID: 3577944610 Enrollment ID: I20230805000033 |
| Provider Name | Georgia L Norgren |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1053400192 PECOS PAC ID: 9830188424 Enrollment ID: I20230816000031 |
| Provider Name | Rebecca L Stillwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639638372 PECOS PAC ID: 5597094326 Enrollment ID: I20231213000683 |
Colville Nation Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 39 Short Cut Rd, Inchelium, WA 99138 Phone: 509-722-7006 | |
Lake Roosevelt Community Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 39 Short Cut Road, Inchelium, WA 99138 Phone: 509-722-7610 | |
Cnchc Inchelium Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 39 Shortcut Road, Inchelium, WA 99138 Phone: 509-722-7006 Fax: 509-722-7021 | |
Inchelium Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 39 Shortcut Road, Inchelium, WA 99138 Phone: 509-722-7006 Fax: 509-722-7021 |