| Hudson's Bay Medical Group, Inc., P.s. | |
|
100 E 33rd St Ste 206 Vancouver WA 98663-2776 | |
| (360) 695-1334 | |
| (360) 992-1159 |
| Full Name | Hudson's Bay Medical Group, Inc., P.s. |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 E 33rd St, Vancouver, Washington |
| Authorized Official Name and Position | Kathy Hintz (ADMINISTRATOR) |
| Authorized Official Contact | 3609921155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hudson's Bay Medical Group, Inc., P.s. 100 E 33rd St Ste 206 Vancouver WA 98663-2776 Ph: (360) 695-1334 | Hudson's Bay Medical Group, Inc., P.s. 100 E 33rd St Ste 206 Vancouver WA 98663-2776 Ph: (360) 695-1334 |
| NPI Number | 1942204664 |
|---|---|
| Provider Enumeration Date | 06/09/2005 |
| Last Update Date | 09/28/2022 |
| Medicare PECOS PAC ID | 7214825629 |
|---|---|
| Medicare Enrollment ID | O20040308000898 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942204664 | NPI | - | NPPES |
| 7870405 | Medicaid | WA |
| Provider Name | Jolanta S Olson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346244043 PECOS PAC ID: 6204924962 Enrollment ID: I20100721000177 |
| Provider Name | Jennifer A Mcdonald |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710981576 PECOS PAC ID: 0446374318 Enrollment ID: I20100830000141 |
| Provider Name | Maria Anna Koscinska |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417951138 PECOS PAC ID: 2163546672 Enrollment ID: I20100903000511 |
| Provider Name | Dennis E Morrisroe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659553741 PECOS PAC ID: 4981884277 Enrollment ID: I20110203000249 |
| Provider Name | Jeffrey S Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407911498 PECOS PAC ID: 5193715795 Enrollment ID: I20111019000974 |
| Provider Name | Jessica M Brandt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316332463 PECOS PAC ID: 9931400785 Enrollment ID: I20151221000703 |
| Provider Name | Kimberly Starr Waldrep |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538408844 PECOS PAC ID: 2264743277 Enrollment ID: I20171031002919 |
| Provider Name | Vanessa Nicholle Monsef |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548937758 PECOS PAC ID: 7618366949 Enrollment ID: I20211108001961 |
| Provider Name | Kersten Larayne Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356963789 PECOS PAC ID: 7416324090 Enrollment ID: I20221110002917 |
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