| |
1412 Sw 43rd Street Ste 315 Renton WA 98057 | |
(425) 272-4600 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 1412 Sw 43rd Street, Renton, Washington |
Authorized Official Name and Position | Celeste Charlene Daye (VP REVENUE CYCLE) |
Authorized Official Contact | 4705533591 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 801280 Kansas City MO 64180-1280 Ph: (425) 272-4600 | 1412 Sw 43rd Street Ste 315 Renton WA 98057 Ph: (425) 272-4600 |
NPI Number | 1568746345 |
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Provider Enumeration Date | 09/28/2011 |
Last Update Date | 08/01/2022 |
Medicare PECOS PAC ID | 5294030425 |
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Medicare Enrollment ID | O20160225000615 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568746345 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Margaret R Adam |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1700812237 PECOS PAC ID: 9032105796 Enrollment ID: I20040420001760 |
Provider Name | Julie Patrick |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629464292 PECOS PAC ID: 1658685334 Enrollment ID: I20150810000800 |
Provider Name | Darrell Benko |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023538139 PECOS PAC ID: 5597036590 Enrollment ID: I20210816002432 |
Provider Name | Angela Howlett Kehrley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104536176 PECOS PAC ID: 6709231046 Enrollment ID: I20231006001300 |
Provider Name | Sean Plank |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528589777 PECOS PAC ID: 8527326198 Enrollment ID: I20240113000577 |
Provider Name | Samantha Campbell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336882778 PECOS PAC ID: 6103365184 Enrollment ID: I20240822003207 |
Provider Name | Maria Neeley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568866572 PECOS PAC ID: 0244779072 Enrollment ID: I20240826000817 |
Provider Name | Archita Sood |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1184913600 PECOS PAC ID: 6507083698 Enrollment ID: I20240828001379 |
Provider Name | Paula Gingles |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518528728 PECOS PAC ID: 2668869702 Enrollment ID: I20241007000574 |
Associated Valley Providers Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4361 Talbot Rd S, Suite 112, Renton, WA 98055 Phone: 425-255-5111 Fax: 425-254-0985 | |
Maranatha Medical Clinic Inc P S Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17900 Talbot Rd S, #101, Renton, WA 98055 Phone: 425-235-9614 Fax: 425-235-1060 | |
Healthpoint Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 400 S 2nd St, Renton, WA 98057 Phone: 425-424-6310 Fax: 425-277-1566 | |
Northwest Neurological & Neurovascular Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Sw 39th St, Suite 150, Renton, WA 98057 Phone: 425-264-2568 Fax: 425-264-2569 |