| Pacific Endometriosis And Pelvic Surgery | |
|
11505 Burnham Dr Ste #302 Gig Harbor WA 98332 | |
| (253) 313-5997 | |
| (253) 313-5179 |
| Full Name | Pacific Endometriosis And Pelvic Surgery |
|---|---|
| Speciality | Clinic/Center |
| Location | 11505 Burnham Dr, Gig Harbor, Washington |
| Authorized Official Name and Position | Cindy Marie Mosbrucker (OWNER) |
| Authorized Official Contact | 2533135997 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Endometriosis And Pelvic Surgery 11505 Burnham Dr Ste #302 Gig Harbor WA 98332 Ph: (253) 313-5997 | Pacific Endometriosis And Pelvic Surgery 11505 Burnham Dr Ste #302 Gig Harbor WA 98332 Ph: (253) 313-5997 |
| NPI Number | 1508227448 |
|---|---|
| Provider Enumeration Date | 03/18/2016 |
| Last Update Date | 11/02/2023 |
| Medicare PECOS PAC ID | 5890081939 |
|---|---|
| Medicare Enrollment ID | O20160915001627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508227448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 60016675 (Washington) | Primary |
| Provider Name | Cynthia M Mosbrucker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467544460 PECOS PAC ID: 0143318832 Enrollment ID: I20080827000583 |
| Provider Name | Sarah Huntington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831531821 PECOS PAC ID: 2567699036 Enrollment ID: I20131209001777 |
| Provider Name | Trista Marie Newville |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528324712 PECOS PAC ID: 9830406461 Enrollment ID: I20190723003643 |
| Provider Name | Crystal L Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962159020 PECOS PAC ID: 3678956141 Enrollment ID: I20220816001720 |
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