| Providence Express Care | |
|
800 Fifth Ave Ste 900 Seattle WA 98104-3179 | |
| (888) 327-3312 | |
| Not Available |
| Full Name | Providence Express Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 Fifth Ave Ste 900, Seattle, Washington |
| Authorized Official Name and Position | Donald W Anderson (ASST SEC FOR ENROLLMENT/DIR REIMB) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Express Care Po Box 3229 Portland OR 97208-3229 Ph: (888) 227-3312 | Providence Express Care 800 Fifth Ave Ste 900 Seattle WA 98104-3179 Ph: (888) 327-3312 |
| NPI Number | 1205499126 |
|---|---|
| Provider Enumeration Date | 04/16/2019 |
| Last Update Date | 10/05/2021 |
| Medicare PECOS PAC ID | 1254768732 |
|---|---|
| Medicare Enrollment ID | O20200221001693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205499126 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Carrie Lynne Myers-cleary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760416325 PECOS PAC ID: 7214927813 Enrollment ID: I20040515000123 |
| Provider Name | Denise M Janetos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467497073 PECOS PAC ID: 9335121672 Enrollment ID: I20040602000363 |
| Provider Name | Kimberly S Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578870069 PECOS PAC ID: 3476781055 Enrollment ID: I20140103000669 |
| Provider Name | Kristin K Loch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730197294 PECOS PAC ID: 1850377102 Enrollment ID: I20141201001540 |
| Provider Name | Taran Engelbart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043555709 PECOS PAC ID: 9436391646 Enrollment ID: I20150917001506 |
| Provider Name | Miriam Carla Sorensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376914879 PECOS PAC ID: 3678874898 Enrollment ID: I20151214000272 |
| Provider Name | Marianna Baghdasaryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164695102 PECOS PAC ID: 9032417860 Enrollment ID: I20160412001651 |
| Provider Name | Bradley W Hilliard-lythgoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376984682 PECOS PAC ID: 0941247332 Enrollment ID: I20160426001220 |
| Provider Name | Dipty Rana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548611973 PECOS PAC ID: 1557656188 Enrollment ID: I20160822002483 |
| Provider Name | Philip Ondara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639611957 PECOS PAC ID: 5193006229 Enrollment ID: I20170104002111 |
| Provider Name | Bonnie E Hinckley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649481896 PECOS PAC ID: 6305913468 Enrollment ID: I20181031000684 |
| Provider Name | Shira Albert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063817831 PECOS PAC ID: 4385985191 Enrollment ID: I20190404000646 |
| Provider Name | Andreana M Gentile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134428378 PECOS PAC ID: 3870737240 Enrollment ID: I20190712001760 |
| Provider Name | Steven Beardsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457903239 PECOS PAC ID: 7416389457 Enrollment ID: I20200224001052 |
| Provider Name | Jennifer L Barden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053866632 PECOS PAC ID: 8729366398 Enrollment ID: I20200416003030 |
| Provider Name | Olubanke Babalola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013329002 PECOS PAC ID: 9133345275 Enrollment ID: I20200605001926 |
| Provider Name | Lori Crane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487245734 PECOS PAC ID: 1658788740 Enrollment ID: I20210408001311 |
| Provider Name | Jonathan Hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003560459 PECOS PAC ID: 7315263209 Enrollment ID: I20220805000638 |
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