Connections Medical Of Wa, Pllc | |
11410 Ne 122nd Way Kirkland WA 98034-6945 | |
(520) 301-2400 | |
Not Available |
Full Name | Connections Medical Of Wa, Pllc |
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Speciality | Clinic/Center |
Location | 11410 Ne 122nd Way, Kirkland, Washington |
Authorized Official Name and Position | Cheryl Boyle (DIRECTOR, CREDENTIALING) |
Authorized Official Contact | 7376006039 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Connections Medical Of Wa, Pllc 2390 E Camelback Rd Phoenix AZ 85016-3448 Ph: () - | Connections Medical Of Wa, Pllc 11410 Ne 122nd Way Kirkland WA 98034-6945 Ph: (520) 301-2400 |
NPI Number | 1073205431 |
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Provider Enumeration Date | 05/24/2023 |
Last Update Date | 05/24/2023 |
Medicare PECOS PAC ID | 0547608390 |
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Medicare Enrollment ID | O20240329001703 |
Identifier | Type | State | Issuer |
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1073205431 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Ikechi Alex Ikechi |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083221006 PECOS PAC ID: 5193132900 Enrollment ID: I20210927002785 |
Provider Name | Okechukwu Kene Aneke |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568046449 PECOS PAC ID: 3173911054 Enrollment ID: I20211026001516 |
Provider Name | Lauren Prest |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1881012235 PECOS PAC ID: 3971804147 Enrollment ID: I20221125000209 |
Provider Name | Wioleta E Bongiorno |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699345926 PECOS PAC ID: 7517324650 Enrollment ID: I20230606001438 |
Provider Name | Ali Kah |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184322042 PECOS PAC ID: 5890142368 Enrollment ID: I20231106003044 |
Provider Name | Kyle H Jasper |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1649703075 PECOS PAC ID: 5799057410 Enrollment ID: I20231201000312 |
Provider Name | Margaret E Balfour |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1912101239 PECOS PAC ID: 1557556669 Enrollment ID: I20240401000400 |
Provider Name | Laura Gatz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992331276 PECOS PAC ID: 2567882129 Enrollment ID: I20240528003034 |
Provider Name | Emmanuella Edekobi |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528849494 PECOS PAC ID: 0648613182 Enrollment ID: I20240812003129 |
Provider Name | Kenneth Afueh Nembu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841810371 PECOS PAC ID: 9335556430 Enrollment ID: I20241120003377 |
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