| Mobile Healthcare Providers Northwest | |
|
415 Se 177th Ave Vancouver WA 98683-4201 | |
| (360) 980-2441 | |
| (877) 491-4990 |
| Full Name | Mobile Healthcare Providers Northwest |
|---|---|
| Speciality | Family Medicine |
| Location | 415 Se 177th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Mary Buckland (OWNER) |
| Authorized Official Contact | 3607737463 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Healthcare Providers Northwest Po Box 728 Camas WA 98607-0728 Ph: (360) 980-2441 | Mobile Healthcare Providers Northwest 415 Se 177th Ave Vancouver WA 98683-4201 Ph: (360) 980-2441 |
| NPI Number | 1306235049 |
|---|---|
| Provider Enumeration Date | 01/19/2015 |
| Last Update Date | 01/26/2022 |
| Medicare PECOS PAC ID | 5496095283 |
|---|---|
| Medicare Enrollment ID | O20190313002494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306235049 | NPI | - | NPPES |
| Provider Name | Eva Nystrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922071422 PECOS PAC ID: 5890769749 Enrollment ID: I20040825000777 |
| Provider Name | Mary I Buckland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912066986 PECOS PAC ID: 7719924307 Enrollment ID: I20080715000615 |
| Provider Name | Charlotte E White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861873325 PECOS PAC ID: 4284941121 Enrollment ID: I20150909003403 |
| Provider Name | Peggy Knowles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821468448 PECOS PAC ID: 7315249638 Enrollment ID: I20160104002074 |
| Provider Name | Charles Tannert Pinney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902819451 PECOS PAC ID: 2163511809 Enrollment ID: I20160204000471 |
| Provider Name | Mara K Sagmiller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760912943 PECOS PAC ID: 6800153313 Enrollment ID: I20200221001098 |
| Provider Name | Megan C Bledsoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780271916 PECOS PAC ID: 3971919416 Enrollment ID: I20210309001233 |
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