Mill Creek Family Practice Pllc | |
1025 153rd St Se Suite 200 Mill Creek WA 98012-4051 | |
(425) 338-4000 | |
(425) 745-6158 |
Full Name | Mill Creek Family Practice Pllc |
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Speciality | Family Medicine |
Location | 1025 153rd St Se, Mill Creek, Washington |
Authorized Official Name and Position | Mark T Anderson (PHYSICIAN) |
Authorized Official Contact | 4253384000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mill Creek Family Practice Pllc 1025 153rd St Se Suite 200 Mill Creek WA 98012-4051 Ph: (425) 338-4000 | Mill Creek Family Practice Pllc 1025 153rd St Se Suite 200 Mill Creek WA 98012-4051 Ph: (425) 338-4000 |
NPI Number | 1598806770 |
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Provider Enumeration Date | 02/09/2007 |
Last Update Date | 02/13/2013 |
Medicare PECOS PAC ID | 8527099456 |
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Medicare Enrollment ID | O20050830000667 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598806770 | NPI | - | NPPES |
7098643 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Matthew G Price |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962426106 PECOS PAC ID: 6305878216 Enrollment ID: I20050831000340 |
Provider Name | William W Bacon |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1396769634 PECOS PAC ID: 4789615618 Enrollment ID: I20050901000406 |
Provider Name | Mark T Anderson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316961659 PECOS PAC ID: 2062444821 Enrollment ID: I20050901000422 |
Provider Name | Stephen S Stukovsky |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1467543306 PECOS PAC ID: 7416042734 Enrollment ID: I20071002000450 |
Provider Name | Swapna Bobba |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1043337918 PECOS PAC ID: 0042389744 Enrollment ID: I20080521000430 |
Provider Name | Leah A Grant |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144470865 PECOS PAC ID: 4789744004 Enrollment ID: I20081117000581 |
Provider Name | Leanna K Winant |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972651198 PECOS PAC ID: 3173838810 Enrollment ID: I20150811003233 |
Provider Name | Brittany A Armstrong Hoss |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730465485 PECOS PAC ID: 4587902291 Enrollment ID: I20190205000847 |
Provider Name | Pamila Joy Ellis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619684891 PECOS PAC ID: 7618346362 Enrollment ID: I20221220000675 |
Provider Name | Haley Anthes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083353841 PECOS PAC ID: 3971985565 Enrollment ID: I20230329001221 |
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