Colville Indian Health Center | |
19 Lakes St Nespelem WA 99155-0071 | |
(509) 634-2900 | |
(509) 634-2990 |
Full Name | Colville Indian Health Center |
---|---|
Speciality | Clinic/Center |
Location | 19 Lakes St, Nespelem, Washington |
Authorized Official Name and Position | Yvonne Misiaszek (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5096342900 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Colville Indian Health Center 19 Lakes St Nespelem WA 99155-0071 Ph: (509) 634-2900 | Colville Indian Health Center 19 Lakes St Nespelem WA 99155-0071 Ph: (509) 634-2900 |
NPI Number | 1811091911 |
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Provider Enumeration Date | 09/11/2006 |
Last Update Date | 05/19/2008 |
Medicare PECOS PAC ID | 0941302509 |
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Medicare Enrollment ID | O20070228000304 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811091911 | NPI | - | NPPES |
7100100 | Medicaid | WA | |
5400189 | Medicaid | WA | |
7139660 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Sandra Roberts |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083653836 PECOS PAC ID: 0648226860 Enrollment ID: I20050330000564 |
Provider Name | Kathy A Winzer |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639191091 PECOS PAC ID: 0840398640 Enrollment ID: I20070601000210 |
Provider Name | Joseph P Santiago |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1285667188 PECOS PAC ID: 1153466214 Enrollment ID: I20100301000959 |
Provider Name | Shayne P Blevins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538305057 PECOS PAC ID: 6507907540 Enrollment ID: I20101028001373 |
Provider Name | Peggy W Williams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275898405 PECOS PAC ID: 1355582545 Enrollment ID: I20130731000363 |
Provider Name | Loren L Lewis |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1275603037 PECOS PAC ID: 0143313817 Enrollment ID: I20150318002091 |
Provider Name | Sheila M Allen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194814822 PECOS PAC ID: 6608975735 Enrollment ID: I20150518000364 |
Provider Name | Gregory Barcus |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1902983562 PECOS PAC ID: 9830221837 Enrollment ID: I20150527001958 |
Provider Name | Jacqueline M Sellner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003213430 PECOS PAC ID: 6507183654 Enrollment ID: I20150624001249 |
Provider Name | Qiyu Huang |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619250131 PECOS PAC ID: 4587838867 Enrollment ID: I20160404000555 |
Provider Name | Melinda K Hoffman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164415006 PECOS PAC ID: 4082701487 Enrollment ID: I20160617000258 |
Provider Name | Debra S Scheel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568468189 PECOS PAC ID: 5496778391 Enrollment ID: I20161202000087 |
Provider Name | Larry Smith |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1639131386 PECOS PAC ID: 8729061189 Enrollment ID: I20170724003308 |
Provider Name | Michael L Turnington |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356890206 PECOS PAC ID: 9830468818 Enrollment ID: I20170822000259 |
Provider Name | Connie I Edwards |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538139027 PECOS PAC ID: 1355233313 Enrollment ID: I20171116002520 |
Provider Name | Phillip Luther Shealy |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811394935 PECOS PAC ID: 3577873264 Enrollment ID: I20171128003355 |
Provider Name | Shauna Robinson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962952028 PECOS PAC ID: 9830456532 Enrollment ID: I20171206000003 |
Provider Name | Emily Poloji |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922491349 PECOS PAC ID: 8729351564 Enrollment ID: I20180103000645 |
Provider Name | Theresa Caniff |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407210172 PECOS PAC ID: 4385905090 Enrollment ID: I20180220002488 |
Provider Name | Robert L Holman |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1225083587 PECOS PAC ID: 7517919095 Enrollment ID: I20180308002306 |
Provider Name | Victoria E Brookshire |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275679961 PECOS PAC ID: 3274762901 Enrollment ID: I20181010000731 |
Provider Name | Alison M Pingitore |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538518113 PECOS PAC ID: 5294028668 Enrollment ID: I20181105000381 |
Provider Name | Judy Ann Fryover |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750574950 PECOS PAC ID: 9133473887 Enrollment ID: I20181115000305 |
Provider Name | Teresa Ellen Myers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013991363 PECOS PAC ID: 1759376759 Enrollment ID: I20181231000307 |
Provider Name | Francoise Bansenga |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275877409 PECOS PAC ID: 8022303213 Enrollment ID: I20190417000399 |
Provider Name | Micheal Scott Feuerborn |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740842053 PECOS PAC ID: 9133551179 Enrollment ID: I20191113002594 |
Provider Name | Cassandra Mitchell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184118275 PECOS PAC ID: 7214261627 Enrollment ID: I20191116000176 |
Provider Name | Deanna A Pritchett |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841779634 PECOS PAC ID: 9537591219 Enrollment ID: I20191119000266 |
Provider Name | Kenya Kawanee Hemingway |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093083420 PECOS PAC ID: 2062679152 Enrollment ID: I20200128000899 |
Provider Name | Andrew J Trego |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1053439331 PECOS PAC ID: 6103255443 Enrollment ID: I20200715003310 |
Provider Name | Michael Blue |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1558309393 PECOS PAC ID: 5991793135 Enrollment ID: I20210115002377 |
Provider Name | Johnna Diane Tunnyhill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245901701 PECOS PAC ID: 0547650467 Enrollment ID: I20211209000038 |
Provider Name | Randall Wiley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013029735 PECOS PAC ID: 5597867465 Enrollment ID: I20211217001285 |
Colville Indian Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 Lakes Street, Nespelem, WA 99155 Phone: 509-634-2900 Fax: 509-634-2990 | |
Colville Indian Health Service Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 Lakes Street, Nespelem, WA 99155 Phone: 509-634-2913 Fax: 509-634-2945 |