| Nooksack Community Clinic | |
|
6760 Mission Rd Everson WA 98247-9749 | |
| (360) 966-2106 | |
| (360) 966-7227 |
| Full Name | Nooksack Community Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 6760 Mission Rd, Everson, Washington |
| Authorized Official Name and Position | John Duncan (NIT CONTROLLER) |
| Authorized Official Contact | 3602962315 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nooksack Community Clinic Po Box 157 Deming WA 98244-0157 Ph: (360) 966-2106 | Nooksack Community Clinic 6760 Mission Rd Everson WA 98247-9749 Ph: (360) 966-2106 |
| NPI Number | 1568528842 |
|---|---|
| Provider Enumeration Date | 12/29/2006 |
| Last Update Date | 03/02/2009 |
| Medicare PECOS PAC ID | 3971651530 |
|---|---|
| Medicare Enrollment ID | O20090508000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568528842 | NPI | - | NPPES |
| 0170843 | Other | WA | LABOR & INDUSTRIES |
| 7084346 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Frank E James |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730248550 PECOS PAC ID: 6800803156 Enrollment ID: I20060313000292 |
| Provider Name | Sara L Sheaffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235168006 PECOS PAC ID: 5799788956 Enrollment ID: I20060809000171 |
| Provider Name | Barbara H Himes |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1073622064 PECOS PAC ID: 5092863167 Enrollment ID: I20090429000066 |
| Provider Name | Ursula Grayce Hein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326078411 PECOS PAC ID: 0446303101 Enrollment ID: I20090729000311 |
| Provider Name | Kathleen A Puderbaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366433864 PECOS PAC ID: 0446412175 Enrollment ID: I20120425000700 |
| Provider Name | Marlene Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831590306 PECOS PAC ID: 5991027682 Enrollment ID: I20180406000150 |
| Provider Name | Meredith A Lafrance |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1144834912 PECOS PAC ID: 3476971524 Enrollment ID: I20210929002752 |
| Provider Name | Montaine L Healy-green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225479413 PECOS PAC ID: 0244620219 Enrollment ID: I20211206002107 |
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