| Moses Lake Community Health Center | |
|
605 S Coolidge St Moses Lake WA 98837-1893 | |
| (509) 765-0674 | |
| (509) 765-6591 |
| Full Name | Moses Lake Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 605 S Coolidge St, Moses Lake, Washington |
| Authorized Official Name and Position | Sheila A Chilson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5097650674 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moses Lake Community Health Center 605 S Coolidge St Moses Lake WA 98837-1893 Ph: (509) 765-0674 | Moses Lake Community Health Center 605 S Coolidge St Moses Lake WA 98837-1893 Ph: (509) 765-0674 |
| NPI Number | 1699862813 |
|---|---|
| Provider Enumeration Date | 10/08/2006 |
| Last Update Date | 08/01/2014 |
| Medicare PECOS PAC ID | 1254235138 |
|---|---|
| Medicare Enrollment ID | O20031121000667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699862813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 601352250 (Washington) | Primary |
| Provider Name | Brian W Rich |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356334809 PECOS PAC ID: 5395631568 Enrollment ID: I20040225000083 |
| Provider Name | Michael R Tolley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063592871 PECOS PAC ID: 2365437019 Enrollment ID: I20040420000904 |
| Provider Name | Jill K Simon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174606297 PECOS PAC ID: 1153316831 Enrollment ID: I20040420001081 |
| Provider Name | David M Munoz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750344149 PECOS PAC ID: 7416944335 Enrollment ID: I20040430000410 |
| Provider Name | Christopher M Zylak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669435905 PECOS PAC ID: 8325037765 Enrollment ID: I20040510001527 |
| Provider Name | Scott Hoefer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316905094 PECOS PAC ID: 6507856507 Enrollment ID: I20040513000068 |
| Provider Name | Robin D Hines |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992768949 PECOS PAC ID: 5092705020 Enrollment ID: I20040513000250 |
| Provider Name | William D Keyes |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457313280 PECOS PAC ID: 2466442223 Enrollment ID: I20040513001246 |
| Provider Name | Michael D Kirsch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275595001 PECOS PAC ID: 3971593765 Enrollment ID: I20040513001436 |
| Provider Name | Terri H Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316900632 PECOS PAC ID: 9335139146 Enrollment ID: I20040514000001 |
| Provider Name | David A Thorne |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124081138 PECOS PAC ID: 2769473305 Enrollment ID: I20040521000370 |
| Provider Name | Robert Leuty Arnett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689637605 PECOS PAC ID: 2668453267 Enrollment ID: I20040528000672 |
| Provider Name | William E Schulte |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043273162 PECOS PAC ID: 2163403775 Enrollment ID: I20040528000720 |
| Provider Name | Christopher S Krejci |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508829524 PECOS PAC ID: 3870576903 Enrollment ID: I20040610000439 |
| Provider Name | Norbert K Yee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437191004 PECOS PAC ID: 2769453521 Enrollment ID: I20040804001087 |
| Provider Name | Ishwar P Bhat |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386607661 PECOS PAC ID: 2466403977 Enrollment ID: I20050407000949 |
| Provider Name | Kenneth J Mccabe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548222136 PECOS PAC ID: 5890755326 Enrollment ID: I20050701000618 |
| Provider Name | Jodi L Bailey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013965177 PECOS PAC ID: 1355357930 Enrollment ID: I20060307000155 |
| Provider Name | Julie R Kaczmark |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124077029 PECOS PAC ID: 8527079979 Enrollment ID: I20060522000075 |
| Provider Name | Sean C Koskinen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407821853 PECOS PAC ID: 4284646308 Enrollment ID: I20060607000267 |
| Provider Name | Edward M Iuliano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154359156 PECOS PAC ID: 2860405925 Enrollment ID: I20060713000320 |
| Provider Name | Shawn R Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285661637 PECOS PAC ID: 5496653164 Enrollment ID: I20060713000329 |
| Provider Name | Gregory P Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962418814 PECOS PAC ID: 4486758224 Enrollment ID: I20070515000201 |
| Provider Name | Robert A Lloyd |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982757613 PECOS PAC ID: 9830296805 Enrollment ID: I20070525000536 |
| Provider Name | Marc Brian Bruce |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386746998 PECOS PAC ID: 1759473515 Enrollment ID: I20070824000052 |
| Provider Name | Terry Chun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194737429 PECOS PAC ID: 6305938119 Enrollment ID: I20070824000424 |
| Provider Name | Timothy S Gormley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043200686 PECOS PAC ID: 5799710158 Enrollment ID: I20070828000630 |
| Provider Name | Richard W Casey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770554859 PECOS PAC ID: 5991891335 Enrollment ID: I20071017000557 |
| Provider Name | Kristine E Kehler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437313640 PECOS PAC ID: 3577624121 Enrollment ID: I20081202000169 |
| Provider Name | Chet R Hunter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235310269 PECOS PAC ID: 4789755984 Enrollment ID: I20090724000684 |
| Provider Name | Dwane T Brittain |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316055015 PECOS PAC ID: 0143226035 Enrollment ID: I20100604000192 |
| Provider Name | David E Holznagel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700064862 PECOS PAC ID: 1951452887 Enrollment ID: I20100707000466 |
| Provider Name | Patrick Cox |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255478525 PECOS PAC ID: 5991855660 Enrollment ID: I20100708000974 |
| Provider Name | Cole Quentin Hemmerling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447262696 PECOS PAC ID: 0345374195 Enrollment ID: I20100816000122 |
| Provider Name | Justin A Frederick |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750582177 PECOS PAC ID: 5799871877 Enrollment ID: I20100819000891 |
| Provider Name | James T Buratto |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467438044 PECOS PAC ID: 3971687823 Enrollment ID: I20100916000102 |
| Provider Name | Sadaf F Zaidi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104129071 PECOS PAC ID: 4981893104 Enrollment ID: I20110104000648 |
| Provider Name | Richard P Nguyen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861655284 PECOS PAC ID: 6800947508 Enrollment ID: I20110404000192 |
| Provider Name | Amy E Henkel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679737241 PECOS PAC ID: 4789861840 Enrollment ID: I20110527000230 |
| Provider Name | John W Bell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376726661 PECOS PAC ID: 3274702246 Enrollment ID: I20120404000510 |
| Provider Name | Jeffrey S Nackos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548451362 PECOS PAC ID: 6507943552 Enrollment ID: I20120410000486 |
| Provider Name | Scott N King |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740359231 PECOS PAC ID: 3173792413 Enrollment ID: I20120508000102 |
| Provider Name | Arpita Swami |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558532085 PECOS PAC ID: 6901945823 Enrollment ID: I20130621000224 |
| Provider Name | Cameron M Beck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154642023 PECOS PAC ID: 4183886161 Enrollment ID: I20130920000462 |
| Provider Name | Carlina M Menjivar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679871362 PECOS PAC ID: 4688822000 Enrollment ID: I20131115000534 |
| Provider Name | Brian D Petersen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538138516 PECOS PAC ID: 3779528542 Enrollment ID: I20140611000371 |
| Provider Name | Morgan S Fife |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437405792 PECOS PAC ID: 1850546508 Enrollment ID: I20140613002282 |
| Provider Name | Irene Cruite |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346559739 PECOS PAC ID: 9335366442 Enrollment ID: I20140813002970 |
| Provider Name | Justin W Stoltzfus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477968436 PECOS PAC ID: 6901025451 Enrollment ID: I20140915001893 |
| Provider Name | John Jamison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699017632 PECOS PAC ID: 1153560289 Enrollment ID: I20141223001569 |
| Provider Name | Steven J Wilhelm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962737528 PECOS PAC ID: 6901120211 Enrollment ID: I20150115000010 |
| Provider Name | Pushpender Gupta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891925921 PECOS PAC ID: 7315180189 Enrollment ID: I20151009001199 |
| Provider Name | Amit A Habbu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538318027 PECOS PAC ID: 2769671973 Enrollment ID: I20160120001055 |
| Provider Name | Joshua Garcia |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437320942 PECOS PAC ID: 1254588031 Enrollment ID: I20160211002630 |
| Provider Name | Zachary A. Winter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659682722 PECOS PAC ID: 0143541748 Enrollment ID: I20160330002368 |
| Provider Name | Ryan Goff |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972823573 PECOS PAC ID: 4183865090 Enrollment ID: I20160331000250 |
| Provider Name | John Michael Gowdy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578874277 PECOS PAC ID: 4284923145 Enrollment ID: I20160516001900 |
| Provider Name | Roy W Zimmer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780609958 PECOS PAC ID: 6709831662 Enrollment ID: I20161201002103 |
| Provider Name | Joel A Brake |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043225469 PECOS PAC ID: 8426032186 Enrollment ID: I20161208000536 |
| Provider Name | David M Bauer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891955027 PECOS PAC ID: 5395914915 Enrollment ID: I20161212000955 |
| Provider Name | Sarsfield P Dougherty |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457396020 PECOS PAC ID: 6901895929 Enrollment ID: I20161212001359 |
| Provider Name | Bruce S Turlington |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922045434 PECOS PAC ID: 4385738970 Enrollment ID: I20161212002112 |
| Provider Name | Adam J Benson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548250426 PECOS PAC ID: 1254432065 Enrollment ID: I20161219001967 |
| Provider Name | David Keaton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578856449 PECOS PAC ID: 1254623671 Enrollment ID: I20161223000431 |
| Provider Name | Seth Brian Gillham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588944847 PECOS PAC ID: 9032417589 Enrollment ID: I20170110002677 |
| Provider Name | Anthony R D Amico |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689794083 PECOS PAC ID: 1850477944 Enrollment ID: I20170123002219 |
| Provider Name | Douglas A Murrey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649470170 PECOS PAC ID: 1951542463 Enrollment ID: I20170207003035 |
| Provider Name | Richard T Dahlen |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1972542173 PECOS PAC ID: 9133117666 Enrollment ID: I20170222002576 |
| Provider Name | Michael A Stewart |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225066459 PECOS PAC ID: 7517956535 Enrollment ID: I20170223000045 |
| Provider Name | Paul H Eikens |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194767418 PECOS PAC ID: 7618992595 Enrollment ID: I20170224002011 |
| Provider Name | Timothy J Mccue |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639254709 PECOS PAC ID: 1951385780 Enrollment ID: I20170302000732 |
| Provider Name | Kyle L Dale |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295916120 PECOS PAC ID: 1153472857 Enrollment ID: I20170313000109 |
| Provider Name | Patrick Edward Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699801720 PECOS PAC ID: 6901078153 Enrollment ID: I20170320002552 |
| Provider Name | Mark W Elliott |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053349415 PECOS PAC ID: 0143315002 Enrollment ID: I20170321002550 |
| Provider Name | Casey Schmitz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710278510 PECOS PAC ID: 0547563116 Enrollment ID: I20170405001784 |
| Provider Name | Mark O Mcvee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780729400 PECOS PAC ID: 6507754330 Enrollment ID: I20170411000976 |
| Provider Name | Suzanne Shaw |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770577942 PECOS PAC ID: 7719946094 Enrollment ID: I20170619002264 |
| Provider Name | Leslie Anderson Russell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730273160 PECOS PAC ID: 1759356421 Enrollment ID: I20170926002442 |
| Provider Name | James Eaton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205826120 PECOS PAC ID: 7618152323 Enrollment ID: I20180104001863 |
| Provider Name | Jacob Pickering |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912240128 PECOS PAC ID: 5193084432 Enrollment ID: I20180112002648 |
| Provider Name | Jason S Vergnani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053604090 PECOS PAC ID: 6002173499 Enrollment ID: I20180115000460 |
| Provider Name | Ashley Marie Diamond |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912416512 PECOS PAC ID: 6103186747 Enrollment ID: I20180130003131 |
| Provider Name | Jade L Regan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295095628 PECOS PAC ID: 4385938224 Enrollment ID: I20180326001919 |
| Provider Name | Garrett Dejesus |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104192301 PECOS PAC ID: 6608145776 Enrollment ID: I20180601001488 |
| Provider Name | Matthew L Mesick |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528327988 PECOS PAC ID: 4082843644 Enrollment ID: I20180703002726 |
| Provider Name | Matthew Hardy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053799981 PECOS PAC ID: 3971805185 Enrollment ID: I20180920001328 |
| Provider Name | Oksana Prychyna |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861768343 PECOS PAC ID: 9931404076 Enrollment ID: I20180928002641 |
| Provider Name | Shawta Sackett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073099875 PECOS PAC ID: 3375895113 Enrollment ID: I20181005002708 |
| Provider Name | Lindsey Anne Duhamel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417443128 PECOS PAC ID: 7517201387 Enrollment ID: I20181205000923 |
| Provider Name | Paige A Flett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730522889 PECOS PAC ID: 8527319789 Enrollment ID: I20190219000169 |
| Provider Name | David A Thayer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871936419 PECOS PAC ID: 0941421911 Enrollment ID: I20190311002053 |
| Provider Name | Tyson Finlinson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265875991 PECOS PAC ID: 6103127998 Enrollment ID: I20190327003305 |
| Provider Name | Robert W Frost |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831538701 PECOS PAC ID: 3678702636 Enrollment ID: I20190401001000 |
| Provider Name | Jace D Hilton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225473465 PECOS PAC ID: 2163720897 Enrollment ID: I20190515002873 |
| Provider Name | Allison A Tillack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821417544 PECOS PAC ID: 9638485436 Enrollment ID: I20190611003732 |
| Provider Name | Scott Matthew Zelasko |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558577981 PECOS PAC ID: 4880831205 Enrollment ID: I20190701000472 |
| Provider Name | Gurpreet S Dhillon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104091495 PECOS PAC ID: 5294998100 Enrollment ID: I20190722002829 |
| Provider Name | Bethany Ann Mulder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093176398 PECOS PAC ID: 3476846486 Enrollment ID: I20190822003209 |
| Provider Name | C Mark Alder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386631927 PECOS PAC ID: 1254314222 Enrollment ID: I20191004001267 |
| Provider Name | Stephanie M Simonson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124177043 PECOS PAC ID: 6406935022 Enrollment ID: I20191108002045 |
| Provider Name | Wendy L Ehieli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588963946 PECOS PAC ID: 9335431360 Enrollment ID: I20191230002252 |
| Provider Name | Richard F Kennard |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1083876353 PECOS PAC ID: 7113211954 Enrollment ID: I20200217001158 |
| Provider Name | Jordan C Castle |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1891080156 PECOS PAC ID: 1951542497 Enrollment ID: I20200318002191 |
| Provider Name | Scott H Bruschwein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659799732 PECOS PAC ID: 4981930989 Enrollment ID: I20200414001717 |
| Provider Name | Philip N Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992116842 PECOS PAC ID: 2769793041 Enrollment ID: I20200422002845 |
| Provider Name | Jason Roth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386976207 PECOS PAC ID: 0143408526 Enrollment ID: I20200501001464 |
| Provider Name | Michael I Posch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821416439 PECOS PAC ID: 4385909530 Enrollment ID: I20200501002413 |
| Provider Name | Elizabeth R Joiner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962821009 PECOS PAC ID: 2668772443 Enrollment ID: I20200501002550 |
| Provider Name | Logan T Mims |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427411651 PECOS PAC ID: 3870886922 Enrollment ID: I20210201001709 |
| Provider Name | Scott Bryk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336245943 PECOS PAC ID: 5698719789 Enrollment ID: I20210216001631 |
| Provider Name | Eric William Graham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689069908 PECOS PAC ID: 2668880527 Enrollment ID: I20210415002017 |
| Provider Name | Mariam N Shehata |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821450537 PECOS PAC ID: 4183915549 Enrollment ID: I20210512001778 |
| Provider Name | Logan Beebe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871970277 PECOS PAC ID: 8628499407 Enrollment ID: I20210521002246 |
| Provider Name | Michael Jaehoon Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356738207 PECOS PAC ID: 7618284639 Enrollment ID: I20210525002841 |
| Provider Name | Rupinder Penna |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972982874 PECOS PAC ID: 9234446394 Enrollment ID: I20210525003421 |
| Provider Name | Ben Hamblin Lecheminant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811378664 PECOS PAC ID: 8628383320 Enrollment ID: I20210528001839 |
| Provider Name | Brent James King |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336520931 PECOS PAC ID: 7416255419 Enrollment ID: I20210601002103 |
| Provider Name | David Holt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942680830 PECOS PAC ID: 1355656877 Enrollment ID: I20210602003198 |
| Provider Name | Rebecca Helton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316466162 PECOS PAC ID: 3678849213 Enrollment ID: I20210727003303 |
| Provider Name | Brian Gump |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508251158 PECOS PAC ID: 6406276914 Enrollment ID: I20220309001520 |
| Provider Name | Samuel Joseph Plesner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588027627 PECOS PAC ID: 3971905894 Enrollment ID: I20220523002097 |
| Provider Name | Matthew Peter Curtis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629423710 PECOS PAC ID: 8628344173 Enrollment ID: I20220601001052 |
| Provider Name | Gregory Kujawski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982054813 PECOS PAC ID: 4284929142 Enrollment ID: I20220606002575 |
| Provider Name | Adam P Skibinski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558725648 PECOS PAC ID: 2365733359 Enrollment ID: I20220606002714 |
| Provider Name | Casey Cable |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801243464 PECOS PAC ID: 0749573293 Enrollment ID: I20220608001922 |
| Provider Name | Ryne Dougherty |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477915890 PECOS PAC ID: 6204127293 Enrollment ID: I20220608002323 |
| Provider Name | Douglas Lorenzo Handley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831552157 PECOS PAC ID: 0244630416 Enrollment ID: I20220608002957 |
| Provider Name | Amy Marie Newton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518314756 PECOS PAC ID: 6800295213 Enrollment ID: I20220610002622 |
| Provider Name | Jedidiah Schlung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386008548 PECOS PAC ID: 7618214933 Enrollment ID: I20220613000787 |
| Provider Name | Michael T Bayona |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811330954 PECOS PAC ID: 4385962265 Enrollment ID: I20221213002418 |
| Provider Name | Francie A Hudak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013567759 PECOS PAC ID: 8729475371 Enrollment ID: I20230214003016 |
| Provider Name | Paul Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801020672 PECOS PAC ID: 1254565955 Enrollment ID: I20230602000596 |
| Provider Name | Tammy J Freese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073058400 PECOS PAC ID: 8527426543 Enrollment ID: I20230623001898 |
| Provider Name | George William Keng |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982091427 PECOS PAC ID: 2163714213 Enrollment ID: I20230630001260 |
| Provider Name | Chen Yin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124559091 PECOS PAC ID: 4486041613 Enrollment ID: I20230703000635 |
| Provider Name | Cory Rasmussen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376992438 PECOS PAC ID: 7719271964 Enrollment ID: I20230731004121 |
| Provider Name | Nathan S Doyle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407381890 PECOS PAC ID: 1153700489 Enrollment ID: I20230831000997 |
| Provider Name | Alexander J Kurdi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356877476 PECOS PAC ID: 6305116278 Enrollment ID: I20230913003550 |
| Provider Name | Heather C Kappel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427721638 PECOS PAC ID: 0446609846 Enrollment ID: I20231211002470 |
| Provider Name | Rachael Anne Sewell |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1871002105 PECOS PAC ID: 3577916212 Enrollment ID: I20240129003513 |
| Provider Name | Mark Sherberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770023277 PECOS PAC ID: 0345517140 Enrollment ID: I20240214002448 |
| Provider Name | Tawnee Tidd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417715780 PECOS PAC ID: 3274972237 Enrollment ID: I20240423004437 |
Healthsource Of Moses Lake Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 W 3rd Ave, Moses Lake, WA 98837 Phone: 509-765-0638 Fax: 509-765-3891 | |
Moses Lake Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 S Coolidge St, Moses Lake, WA 98837 Phone: 509-764-0674 Fax: 509-764-0344 | |
Omni Staffing Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1530 Pilgrim St, Moses Lake, WA 98837 Phone: 509-855-5497 Fax: 509-639-7063 | |
Parkview Pediatrics Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 S Division St, Moses Lake, WA 98837 Phone: 509-766-9450 Fax: 509-766-1954 | |
Pacific Rehabilitation Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 E Broadway Ave Ste 11, Moses Lake, WA 98837 Phone: 425-513-8509 Fax: 425-290-9774 | |
Moses Lake Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 S Coolidge St, Moses Lake, WA 98837 Phone: 509-765-0674 Fax: 509-765-6591 | |
Aion Womens Health Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1022 S Pioneer Way Ste A, Moses Lake, WA 98837 Phone: 509-762-2466 Fax: 509-762-2465 |