| Lopez Island Medical Clinic | |
|
103 Washburn Lopez WA 98261 | |
| (360) 468-2245 | |
| Not Available |
| Full Name | Lopez Island Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 103 Washburn, Lopez, Washington |
| Authorized Official Name and Position | Elise J Cutter (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3602991301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lopez Island Medical Clinic 1211 24th St Anacortes WA 98221-2557 Ph: (360) 299-1300 | Lopez Island Medical Clinic 103 Washburn Lopez WA 98261 Ph: (360) 468-2245 |
| NPI Number | 1740203967 |
|---|---|
| Provider Enumeration Date | 07/26/2006 |
| Last Update Date | 01/25/2013 |
| Medicare PECOS PAC ID | 1153225198 |
|---|---|
| Medicare Enrollment ID | O20031121000440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740203967 | NPI | - | NPPES |
| 7048069 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | H134 (Washington) | Primary |
| Provider Name | Robert J Raish |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1689757775 PECOS PAC ID: 6305744673 Enrollment ID: I20040407000247 |
| Provider Name | Laurence Cambron |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417924242 PECOS PAC ID: 6103815360 Enrollment ID: I20040511001579 |
| Provider Name | Tomasz M Ziedalski |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1265473854 PECOS PAC ID: 8426039520 Enrollment ID: I20040623000672 |
| Provider Name | Jedediah A Kaufman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043228422 PECOS PAC ID: 3072591973 Enrollment ID: I20040708000490 |
| Provider Name | Jon T Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669553723 PECOS PAC ID: 0244218741 Enrollment ID: I20040712000279 |
| Provider Name | Karen S Dec |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043284862 PECOS PAC ID: 8123099108 Enrollment ID: I20040803001484 |
| Provider Name | Muneer Janak Desai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376516021 PECOS PAC ID: 4688645591 Enrollment ID: I20040804000603 |
| Provider Name | Scott D Harrison |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558335372 PECOS PAC ID: 9931170859 Enrollment ID: I20040804000707 |
| Provider Name | Allen H Horesh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447345806 PECOS PAC ID: 3476520925 Enrollment ID: I20040914000516 |
| Provider Name | Julia R Seavello |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1164453882 PECOS PAC ID: 1254381700 Enrollment ID: I20050124000388 |
| Provider Name | Elaine A Armantrout |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619012929 PECOS PAC ID: 5991759706 Enrollment ID: I20050304000097 |
| Provider Name | Charles V Kotal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104888361 PECOS PAC ID: 8820044431 Enrollment ID: I20050328000306 |
| Provider Name | Bridgett M Bell Kraft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780625400 PECOS PAC ID: 2961429394 Enrollment ID: I20051025001064 |
| Provider Name | Jeffrey S Hambleton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861548307 PECOS PAC ID: 7517903289 Enrollment ID: I20051108000414 |
| Provider Name | Frank E James |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730248550 PECOS PAC ID: 6800803156 Enrollment ID: I20060313000292 |
| Provider Name | Nancy H Llewellyn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760576474 PECOS PAC ID: 7517859176 Enrollment ID: I20060505000061 |
| Provider Name | Jason G Hogge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598795783 PECOS PAC ID: 6507826104 Enrollment ID: I20061021000020 |
| Provider Name | Feiyu Xue |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225008568 PECOS PAC ID: 5395727580 Enrollment ID: I20061026000150 |
| Provider Name | Patricia A Franklin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053307017 PECOS PAC ID: 6608874268 Enrollment ID: I20061116000068 |
| Provider Name | Erin P Rieger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942393426 PECOS PAC ID: 7315947611 Enrollment ID: I20070111000070 |
| Provider Name | Brian A Kendregan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841295870 PECOS PAC ID: 2062491434 Enrollment ID: I20070305000413 |
| Provider Name | Donald E Wakelin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790820546 PECOS PAC ID: 5193825982 Enrollment ID: I20070709000475 |
| Provider Name | Bruce C Mathey |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1366497463 PECOS PAC ID: 6204898448 Enrollment ID: I20070723000703 |
| Provider Name | David C Hall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386771160 PECOS PAC ID: 0547353658 Enrollment ID: I20070926000357 |
| Provider Name | Bryan P Potter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316967045 PECOS PAC ID: 4981692431 Enrollment ID: I20071108000131 |
| Provider Name | Mehrdad Jafari Boroujerdi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1922076173 PECOS PAC ID: 8628049301 Enrollment ID: I20071213000702 |
| Provider Name | Susan M Sandblom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396944013 PECOS PAC ID: 5799861217 Enrollment ID: I20080325000265 |
| Provider Name | Jaroslaw Kotlarczyk |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972661296 PECOS PAC ID: 9830080738 Enrollment ID: I20080430000698 |
| Provider Name | William D Rubin |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1477550796 PECOS PAC ID: 6800975194 Enrollment ID: I20080512000749 |
| Provider Name | Jesse J Kincaid |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093835829 PECOS PAC ID: 6103997333 Enrollment ID: I20080616000790 |
| Provider Name | Leah N Kiviat |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083716617 PECOS PAC ID: 6800968728 Enrollment ID: I20080709000210 |
| Provider Name | Kelley L Cline |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497941504 PECOS PAC ID: 4486729605 Enrollment ID: I20080821000490 |
| Provider Name | Evan Buxbaum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174633069 PECOS PAC ID: 6507822632 Enrollment ID: I20081015000104 |
| Provider Name | Claude L Conway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144399502 PECOS PAC ID: 4082771894 Enrollment ID: I20090324000010 |
| Provider Name | Kathleen A Garde |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821168865 PECOS PAC ID: 0446317259 Enrollment ID: I20090324000016 |
| Provider Name | John R Mathis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780754739 PECOS PAC ID: 3072670884 Enrollment ID: I20090324000021 |
| Provider Name | Azile H Franciose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740359116 PECOS PAC ID: 6901963727 Enrollment ID: I20090324000100 |
| Provider Name | Mark S Backman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073682423 PECOS PAC ID: 1456260645 Enrollment ID: I20090325000474 |
| Provider Name | Kristine E Schmaltz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932268760 PECOS PAC ID: 0648327403 Enrollment ID: I20090413000479 |
| Provider Name | Sameh Salama |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285700328 PECOS PAC ID: 0446307078 Enrollment ID: I20090416000270 |
| Provider Name | Jonathan Jaksha |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871555649 PECOS PAC ID: 3274632054 Enrollment ID: I20090528000535 |
| Provider Name | Jamie R Wong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306972534 PECOS PAC ID: 4385714971 Enrollment ID: I20090630000449 |
| Provider Name | Daniel Dt Pham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568658524 PECOS PAC ID: 5092880633 Enrollment ID: I20090717000305 |
| Provider Name | Elizabeth C Goetter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093828774 PECOS PAC ID: 4284787722 Enrollment ID: I20090731000468 |
| Provider Name | Kiarash Kojouri |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1841243060 PECOS PAC ID: 7315958469 Enrollment ID: I20090914000443 |
| Provider Name | Ellen Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760408850 PECOS PAC ID: 7517981244 Enrollment ID: I20090914000634 |
| Provider Name | Joseph W Mulcahy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265515043 PECOS PAC ID: 9234285735 Enrollment ID: I20090924000737 |
| Provider Name | Julia Overstreet |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1720283997 PECOS PAC ID: 1456254051 Enrollment ID: I20100308000936 |
| Provider Name | Tari Lynn Roche |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528080678 PECOS PAC ID: 3173658135 Enrollment ID: I20100316000209 |
| Provider Name | Oliver L Stalsbroten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417062902 PECOS PAC ID: 1254321151 Enrollment ID: I20100624000904 |
| Provider Name | Robert A Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427150473 PECOS PAC ID: 7810020393 Enrollment ID: I20100804000657 |
| Provider Name | Mansel K Kevwitch |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1568540771 PECOS PAC ID: 6103713912 Enrollment ID: I20100816000940 |
| Provider Name | Catherine L Doherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942303441 PECOS PAC ID: 3274657135 Enrollment ID: I20100828000204 |
| Provider Name | Jody Ann Cousins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467578799 PECOS PAC ID: 1254456700 Enrollment ID: I20100921000617 |
| Provider Name | Nadine B Foist |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386709863 PECOS PAC ID: 3870781404 Enrollment ID: I20101227000585 |
| Provider Name | Robert G Billow |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1689672552 PECOS PAC ID: 1759413032 Enrollment ID: I20110103000771 |
| Provider Name | Ann M Hendrzak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558426502 PECOS PAC ID: 8628964723 Enrollment ID: I20110201000205 |
| Provider Name | Seth D Hartung |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043337751 PECOS PAC ID: 5799965422 Enrollment ID: I20110211000536 |
| Provider Name | Jocelyn I I Palmer Perry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700177698 PECOS PAC ID: 8123205176 Enrollment ID: I20110531000683 |
| Provider Name | Junfeng Wang |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1154533412 PECOS PAC ID: 1254509045 Enrollment ID: I20110721000715 |
| Provider Name | Susanne Wilhelm |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1780819722 PECOS PAC ID: 4183898927 Enrollment ID: I20111114000398 |
| Provider Name | Robert W Carter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1033171475 PECOS PAC ID: 1153577077 Enrollment ID: I20120809000095 |
| Provider Name | Natalie Jarbo Davidson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376766659 PECOS PAC ID: 7214014562 Enrollment ID: I20121128000390 |
| Provider Name | Arthur Molina |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1699718007 PECOS PAC ID: 4789662685 Enrollment ID: I20130319000180 |
| Provider Name | Geoffrey L Godfrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689610925 PECOS PAC ID: 4486716529 Enrollment ID: I20130611000701 |
| Provider Name | Helen Y Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386622215 PECOS PAC ID: 8325082555 Enrollment ID: I20130709000358 |
| Provider Name | Rayoung Chung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588002976 PECOS PAC ID: 8921249178 Enrollment ID: I20130730000835 |
| Provider Name | Nancy Sara Mansell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376751859 PECOS PAC ID: 2769608710 Enrollment ID: I20140728001359 |
| Provider Name | Jeri N Rudolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831475409 PECOS PAC ID: 9234303348 Enrollment ID: I20140815001985 |
| Provider Name | Bridget Bush |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558444687 PECOS PAC ID: 6002040250 Enrollment ID: I20140922002825 |
| Provider Name | Diana I Bartlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023413358 PECOS PAC ID: 4385967629 Enrollment ID: I20141218000026 |
| Provider Name | Lindsay A Newlon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881954279 PECOS PAC ID: 1254571995 Enrollment ID: I20150717000690 |
| Provider Name | Morgan F Merrill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538324892 PECOS PAC ID: 3173795747 Enrollment ID: I20150929001016 |
| Provider Name | Kirsten Pickard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285030593 PECOS PAC ID: 1153639851 Enrollment ID: I20150930000044 |
| Provider Name | Susan Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326418187 PECOS PAC ID: 9436452133 Enrollment ID: I20160128002376 |
| Provider Name | Aaron Bertoni |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245596881 PECOS PAC ID: 7618260332 Enrollment ID: I20160719001311 |
| Provider Name | Xi Bei Tian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316238090 PECOS PAC ID: 2365735289 Enrollment ID: I20160728002543 |
| Provider Name | Miriam E Levi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538432323 PECOS PAC ID: 3476797838 Enrollment ID: I20160831000366 |
| Provider Name | Danah Peace-laws |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619327665 PECOS PAC ID: 7012203946 Enrollment ID: I20160901000983 |
| Provider Name | Phillip A Bilderback |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386968329 PECOS PAC ID: 9335385814 Enrollment ID: I20161117002089 |
| Provider Name | Jacynda Wheeler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093158412 PECOS PAC ID: 8123252426 Enrollment ID: I20170629000806 |
| Provider Name | Joseph E. Wilson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043338676 PECOS PAC ID: 0446292973 Enrollment ID: I20170630002027 |
| Provider Name | Brittany Leigh Tabler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679830566 PECOS PAC ID: 8628343043 Enrollment ID: I20171010002452 |
| Provider Name | Judah Slavkovsky |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538489224 PECOS PAC ID: 8123266673 Enrollment ID: I20171107002708 |
| Provider Name | Jennifer Marie Kapolchok |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790014215 PECOS PAC ID: 2163788795 Enrollment ID: I20171114002198 |
| Provider Name | Erin J Flanigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861913584 PECOS PAC ID: 9931465481 Enrollment ID: I20171115003855 |
| Provider Name | Leanne Mika Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609387588 PECOS PAC ID: 5799043246 Enrollment ID: I20171211002582 |
| Provider Name | Rachel Marie Parmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811400179 PECOS PAC ID: 2668731217 Enrollment ID: I20180105001146 |
| Provider Name | Greg G. Monaghan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1295706679 PECOS PAC ID: 9739152547 Enrollment ID: I20180423002310 |
| Provider Name | Rodger William Althoff |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417906991 PECOS PAC ID: 1355380007 Enrollment ID: I20180905002999 |
| Provider Name | Sunny Hwang-oras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104315449 PECOS PAC ID: 0143573857 Enrollment ID: I20181026001053 |
| Provider Name | Brian Minow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518395623 PECOS PAC ID: 0143443127 Enrollment ID: I20181105002237 |
| Provider Name | James M Abbey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447646039 PECOS PAC ID: 6305144577 Enrollment ID: I20181107002653 |
| Provider Name | Paul Stephen Hammer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932180502 PECOS PAC ID: 9638475973 Enrollment ID: I20190225002837 |
| Provider Name | Joann F Eastman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881044147 PECOS PAC ID: 3274779574 Enrollment ID: I20190320001446 |
| Provider Name | Sharon P Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093299547 PECOS PAC ID: 5890048912 Enrollment ID: I20190320001995 |
| Provider Name | Kathryn Kay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609348994 PECOS PAC ID: 2466792452 Enrollment ID: I20190329001831 |
| Provider Name | Mark J Sanders |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376571620 PECOS PAC ID: 9133025505 Enrollment ID: I20190408001635 |
| Provider Name | Coralie Sophie Meslin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124516455 PECOS PAC ID: 0840533741 Enrollment ID: I20190516001062 |
| Provider Name | Kelly E Fellows |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154708873 PECOS PAC ID: 0143563601 Enrollment ID: I20190524000489 |
| Provider Name | Michael A Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700359445 PECOS PAC ID: 1658604442 Enrollment ID: I20190611000322 |
| Provider Name | Melissa L Hedlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467926238 PECOS PAC ID: 7810220506 Enrollment ID: I20190612001439 |
| Provider Name | Niket Nathani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801113154 PECOS PAC ID: 3173760725 Enrollment ID: I20190621000949 |
| Provider Name | Abigail Denise Doyle |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1861755498 PECOS PAC ID: 0345462305 Enrollment ID: I20190621001227 |
| Provider Name | Keri Elizabeth Weigle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235365990 PECOS PAC ID: 1153569850 Enrollment ID: I20190722001407 |
| Provider Name | Caitlin Maccoun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376906586 PECOS PAC ID: 3678851946 Enrollment ID: I20190725001015 |
| Provider Name | Kieran Melody |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386949709 PECOS PAC ID: 6204172877 Enrollment ID: I20190815000998 |
| Provider Name | Vola Harivony Le Roux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710422399 PECOS PAC ID: 2668755984 Enrollment ID: I20191127001251 |
| Provider Name | Alan Craig Thom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134539851 PECOS PAC ID: 5092934893 Enrollment ID: I20191216000787 |
| Provider Name | Andrea Arta Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881873388 PECOS PAC ID: 6204913130 Enrollment ID: I20200520002685 |
| Provider Name | Susan L Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174150270 PECOS PAC ID: 4385066711 Enrollment ID: I20200612000124 |
| Provider Name | Stephen M Horras |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225476625 PECOS PAC ID: 0941509962 Enrollment ID: I20200716001556 |
| Provider Name | Shad Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184043010 PECOS PAC ID: 5395036602 Enrollment ID: I20200817003404 |
| Provider Name | Cynthia Gene Stevenson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962001487 PECOS PAC ID: 8820409667 Enrollment ID: I20201130000816 |
| Provider Name | Stefani K Castro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881042265 PECOS PAC ID: 2769894849 Enrollment ID: I20201214002727 |
| Provider Name | Jennifer J. Crew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184236143 PECOS PAC ID: 6901219096 Enrollment ID: I20210111000451 |
| Provider Name | Omeed Azizirad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386707651 PECOS PAC ID: 4981746443 Enrollment ID: I20210308002703 |
| Provider Name | David B Rice |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1740232248 PECOS PAC ID: 2668376104 Enrollment ID: I20210426002832 |
| Provider Name | Mark Donovan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457695546 PECOS PAC ID: 9234484726 Enrollment ID: I20210713003562 |
| Provider Name | Valerie Horn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891146502 PECOS PAC ID: 8123357043 Enrollment ID: I20220329000639 |
| Provider Name | Israel Villanueva |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1134297161 PECOS PAC ID: 7214022672 Enrollment ID: I20220509001816 |
| Provider Name | Darshan R Dhingani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053547968 PECOS PAC ID: 3274797196 Enrollment ID: I20220517001304 |
| Provider Name | Doan Luu |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1447443270 PECOS PAC ID: 3173683216 Enrollment ID: I20220714001720 |
| Provider Name | Elke Neuenschwander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750944740 PECOS PAC ID: 8729314299 Enrollment ID: I20220728003262 |
| Provider Name | Roman Bernstein |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1669600607 PECOS PAC ID: 8426392135 Enrollment ID: I20220809001557 |
| Provider Name | Michael Marsh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1689961591 PECOS PAC ID: 1052636008 Enrollment ID: I20220811003728 |
| Provider Name | Yoosif Mohamed Ali Abdalla |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1679851760 PECOS PAC ID: 6103059803 Enrollment ID: I20220812001298 |
| Provider Name | Jayaraman Chandrasekhar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1134233851 PECOS PAC ID: 2062459134 Enrollment ID: I20220815000624 |
| Provider Name | Sarah C Vangaasbeek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770018707 PECOS PAC ID: 5092049379 Enrollment ID: I20220817001426 |
| Provider Name | Monica Jacobus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144457250 PECOS PAC ID: 9234388109 Enrollment ID: I20220823004220 |
| Provider Name | Sara Weeks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285137091 PECOS PAC ID: 8921355470 Enrollment ID: I20220825003669 |
| Provider Name | Ali Salari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598898579 PECOS PAC ID: 7315038528 Enrollment ID: I20221018003669 |
| Provider Name | Jeffrey Krause |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1902167497 PECOS PAC ID: 7517388515 Enrollment ID: I20221019002833 |
| Provider Name | Edward Burrus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780656595 PECOS PAC ID: 7416008859 Enrollment ID: I20221128003057 |
| Provider Name | Laura Marie Cardinal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326761099 PECOS PAC ID: 1456729235 Enrollment ID: I20221129001651 |
| Provider Name | Julie Ann Watters |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750729612 PECOS PAC ID: 7113388976 Enrollment ID: I20230727000236 |
| Provider Name | Jason Blair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609371830 PECOS PAC ID: 9436547676 Enrollment ID: I20230901000223 |
| Provider Name | Brittany Whitaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821585928 PECOS PAC ID: 5698024172 Enrollment ID: I20231013001446 |
| Provider Name | Jennifer Lynn Simpson Manske |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659309235 PECOS PAC ID: 4789676420 Enrollment ID: I20231024003669 |
| Provider Name | Sharon L Thwing |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598747305 PECOS PAC ID: 2567483290 Enrollment ID: I20231103001318 |
| Provider Name | Janelle Peranteau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396517165 PECOS PAC ID: 3678920477 Enrollment ID: I20231116001429 |
| Provider Name | Elizabeth Fiscus Waring |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659781896 PECOS PAC ID: 1951525955 Enrollment ID: I20240125004795 |
| Provider Name | Shoaib Fakhri |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1992200844 PECOS PAC ID: 6901152099 Enrollment ID: I20240418001133 |
Lopez Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 Washburn, Lopez, WA 98261 Phone: 360-468-2245 |