| Eagle Eye Care | |
|
1051 S. Columbia Avenue Connell WA 99326 | |
| (509) 488-5256 | |
| (509) 488-9939 |
| Full Name | Eagle Eye Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1051 S. Columbia Avenue, Connell, Washington |
| Authorized Official Name and Position | Nieves Gomez (CEO) |
| Authorized Official Contact | 5094885256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Eye Care 1515 E Columbia St Othello WA 99344-1846 Ph: (509) 488-5256 | Eagle Eye Care 1051 S. Columbia Avenue Connell WA 99326 Ph: (509) 488-5256 |
| NPI Number | 1528316379 |
|---|---|
| Provider Enumeration Date | 08/28/2012 |
| Last Update Date | 05/06/2022 |
| Medicare PECOS PAC ID | 4486564309 |
|---|---|
| Medicare Enrollment ID | O20040209000250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528316379 | NPI | - | NPPES |
| 7107675 | Other | WA | UGS MDC DSHS CROSSOVER |
| CO3323 | Other | WA | RAILROAD MEDICARE |
| 8908941 | Other | WA | DLI CRIME VICTIMS# |
| 0035900 | Other | WA | DLI GROUP# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Washington) | Primary |
| Provider Name | Brian W Rich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356334809 PECOS PAC ID: 5395631568 Enrollment ID: I20040225000083 |
| Provider Name | Gabriel W Barrio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477507093 PECOS PAC ID: 4880583251 Enrollment ID: I20040312001200 |
| Provider Name | David M Munoz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750344149 PECOS PAC ID: 7416944335 Enrollment ID: I20040430000410 |
| Provider Name | Trent A Sanders |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164485504 PECOS PAC ID: 7113915208 Enrollment ID: I20040505001707 |
| Provider Name | James P Wilhelm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295798726 PECOS PAC ID: 0547259970 Enrollment ID: I20040510001500 |
| Provider Name | Christopher M Zylak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669435905 PECOS PAC ID: 8325037765 Enrollment ID: I20040510001527 |
| Provider Name | Robin D Hines |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992768949 PECOS PAC ID: 5092705020 Enrollment ID: I20040513000250 |
| Provider Name | William D Keyes |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457313280 PECOS PAC ID: 2466442223 Enrollment ID: I20040513001246 |
| Provider Name | Michael D Kirsch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275595001 PECOS PAC ID: 3971593765 Enrollment ID: I20040513001436 |
| Provider Name | Terri H Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316900632 PECOS PAC ID: 9335139146 Enrollment ID: I20040514000001 |
| Provider Name | Hung Miu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760552525 PECOS PAC ID: 8022009059 Enrollment ID: I20040519001092 |
| Provider Name | Robert Leuty Arnett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689637605 PECOS PAC ID: 2668453267 Enrollment ID: I20040528000672 |
| Provider Name | Norbert K Yee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437191004 PECOS PAC ID: 2769453521 Enrollment ID: I20040804001087 |
| Provider Name | Bashar Elali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265591523 PECOS PAC ID: 1355394545 Enrollment ID: I20050228000930 |
| Provider Name | Ishwar P Bhat |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386607661 PECOS PAC ID: 2466403977 Enrollment ID: I20050407000949 |
| Provider Name | Ruby Farooqi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235216318 PECOS PAC ID: 1658319264 Enrollment ID: I20050422000643 |
| Provider Name | Kenneth J Mccabe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548222136 PECOS PAC ID: 5890755326 Enrollment ID: I20050701000618 |
| Provider Name | Catherine Jane C Dinglasan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285711986 PECOS PAC ID: 0446288005 Enrollment ID: I20050803001075 |
| Provider Name | Jodi L Bailey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013965177 PECOS PAC ID: 1355357930 Enrollment ID: I20060307000155 |
| Provider Name | Jaeniffer Ang Kaiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598749590 PECOS PAC ID: 1951310705 Enrollment ID: I20060406000331 |
| Provider Name | Paula J Shepherd |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164566675 PECOS PAC ID: 8022113513 Enrollment ID: I20070411000292 |
| Provider Name | Robert A Lloyd |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982757613 PECOS PAC ID: 9830296805 Enrollment ID: I20070525000536 |
| Provider Name | Francisco M Chan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124217716 PECOS PAC ID: 0941398622 Enrollment ID: I20071113000678 |
| Provider Name | Brandon R Walters |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699944181 PECOS PAC ID: 7810056595 Enrollment ID: I20081110000776 |
| Provider Name | Monique A Small |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598902355 PECOS PAC ID: 2062569643 Enrollment ID: I20090420000000 |
| Provider Name | Amy E Henkel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679737241 PECOS PAC ID: 4789861840 Enrollment ID: I20110527000230 |
| Provider Name | John W Bell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376726661 PECOS PAC ID: 3274702246 Enrollment ID: I20120404000510 |
| Provider Name | Jeffrey S Nackos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548451362 PECOS PAC ID: 6507943552 Enrollment ID: I20120410000486 |
| Provider Name | Scott N King |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740359231 PECOS PAC ID: 3173792413 Enrollment ID: I20120508000102 |
| Provider Name | Jason Michael Bleazard |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467734889 PECOS PAC ID: 1951567213 Enrollment ID: I20120801000022 |
| Provider Name | Brian L Freeman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1164743720 PECOS PAC ID: 8426299306 Enrollment ID: I20130719000326 |
| Provider Name | Joeun Gilland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831524008 PECOS PAC ID: 5698901502 Enrollment ID: I20131125001199 |
| Provider Name | Alaa Atfeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447680111 PECOS PAC ID: 8022233816 Enrollment ID: I20140711000637 |
| Provider Name | Callin Passey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508020363 PECOS PAC ID: 1951450485 Enrollment ID: I20150824000969 |
| Provider Name | Laura Anne Ely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003263872 PECOS PAC ID: 1355629080 Enrollment ID: I20161031001030 |
| Provider Name | Michelle Ann Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386007409 PECOS PAC ID: 7517257819 Enrollment ID: I20170711001848 |
| Provider Name | Syed Gillani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841603495 PECOS PAC ID: 9537468343 Enrollment ID: I20170811001183 |
| Provider Name | Matthew S Painter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790724987 PECOS PAC ID: 6709898646 Enrollment ID: I20180302001327 |
| Provider Name | Robert D Forbes |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578665253 PECOS PAC ID: 0840349320 Enrollment ID: I20180710001407 |
| Provider Name | Jonathan Jay Walker |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548642622 PECOS PAC ID: 1759621071 Enrollment ID: I20190325001611 |
| Provider Name | Vanessa A Frank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275983975 PECOS PAC ID: 4789969072 Enrollment ID: I20190424002637 |
| Provider Name | Karlee Marie Kerr |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1649545526 PECOS PAC ID: 5799015764 Enrollment ID: I20190918001959 |
| Provider Name | Colin B Mckay |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1417486606 PECOS PAC ID: 0840563847 Enrollment ID: I20200630000436 |
| Provider Name | Tiffany Rochelle Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558788364 PECOS PAC ID: 2567888274 Enrollment ID: I20200812001278 |
| Provider Name | Loren P Knebl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821608647 PECOS PAC ID: 6305259607 Enrollment ID: I20210105003280 |
| Provider Name | Flower Star |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1124646260 PECOS PAC ID: 8729492962 Enrollment ID: I20210128002249 |
| Provider Name | Nisha Sharoff Ashwin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1720579378 PECOS PAC ID: 8123427796 Enrollment ID: I20210721004075 |
| Provider Name | Deyanira Gonzalez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689181810 PECOS PAC ID: 0345646642 Enrollment ID: I20210913001821 |
| Provider Name | Melissa L Lohman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598301160 PECOS PAC ID: 7618301458 Enrollment ID: I20211013001149 |
| Provider Name | Tamara J Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235891854 PECOS PAC ID: 9739572660 Enrollment ID: I20220216002667 |
| Provider Name | Veniel Omar Garza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497214209 PECOS PAC ID: 6709265960 Enrollment ID: I20220617000488 |
| Provider Name | Jonathan Hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003560459 PECOS PAC ID: 7315263209 Enrollment ID: I20220805000638 |
| Provider Name | Bianca Mendoza |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306572326 PECOS PAC ID: 9537542667 Enrollment ID: I20220822003121 |
| Provider Name | Magalie Roman-estrada |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144616731 PECOS PAC ID: 2668847096 Enrollment ID: I20230417001320 |
| Provider Name | Trent Z Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093401341 PECOS PAC ID: 3274991005 Enrollment ID: I20230626002863 |
| Provider Name | Sahira L Ramirez |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1205534567 PECOS PAC ID: 3476912163 Enrollment ID: I20230628002813 |
| Provider Name | Shola Adewunmi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073168449 PECOS PAC ID: 4082946074 Enrollment ID: I20230907001240 |
| Provider Name | Andrew Daniel Horne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982480760 PECOS PAC ID: 0345697371 Enrollment ID: I20231113000776 |
| Provider Name | Angelica Lauriano-eldred |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760904122 PECOS PAC ID: 3173988482 Enrollment ID: I20240104002620 |
| Provider Name | Rebecca K Stuart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659133353 PECOS PAC ID: 5193160505 Enrollment ID: I20240226000957 |
| Provider Name | Rebecca Pendell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366223471 PECOS PAC ID: 3072055425 Enrollment ID: I20240613000003 |
| Provider Name | Jazmine Desiree Martinez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649030065 PECOS PAC ID: 5991248239 Enrollment ID: I20240614003158 |
Lourdes Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 650 S Columbia Ave, Connell, WA 99326 Phone: 509-234-3410 Fax: 509-543-2488 | |
Ang Medical Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 661 South Columbia Ave, Connell, WA 99326 Phone: 509-234-0866 Fax: 509-234-0818 | |
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Connell Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1051 S Columbia Ave, Connell, WA 99326 Phone: 509-234-0866 Fax: 509-488-9939 |