| Pacifica Medicine And Wellness | |
|
19036 Front St Ne # 100 Poulsbo WA 98370-7354 | |
| (360) 979-0569 | |
| Not Available |
| Full Name | Pacifica Medicine And Wellness |
|---|---|
| Speciality | Family Medicine |
| Location | 19036 Front St Ne # 100, Poulsbo, Washington |
| Authorized Official Name and Position | Marie Elaine Matty (PRESIDENT) |
| Authorized Official Contact | 3609790569 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacifica Medicine And Wellness Po Box 2940 Poulsbo WA 98370-2940 Ph: (360) 979-0569 | Pacifica Medicine And Wellness 19036 Front St Ne # 100 Poulsbo WA 98370-7354 Ph: (360) 979-0569 |
| NPI Number | 1982073235 |
|---|---|
| Provider Enumeration Date | 09/16/2015 |
| Last Update Date | 07/27/2024 |
| Medicare PECOS PAC ID | 9133421597 |
|---|---|
| Medicare Enrollment ID | O20151231001794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982073235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD00041619 (Washington) | Primary |
| Provider Name | Sarah A Rice |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780662171 PECOS PAC ID: 6709876709 Enrollment ID: I20040513000051 |
| Provider Name | Marie E Matty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740224880 PECOS PAC ID: 2668419649 Enrollment ID: I20050412000131 |
| Provider Name | Andrea L Chymiy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871543900 PECOS PAC ID: 0648217554 Enrollment ID: I20050412001329 |
| Provider Name | Viola G Medina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679629661 PECOS PAC ID: 4486789104 Enrollment ID: I20100319000853 |
| Provider Name | Charles A Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184863193 PECOS PAC ID: 0547428534 Enrollment ID: I20120222000380 |
| Provider Name | Erica F Hickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649680695 PECOS PAC ID: 3779702683 Enrollment ID: I20140908001884 |
| Provider Name | Gabriela M Cash |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285297275 PECOS PAC ID: 4789917428 Enrollment ID: I20220303001590 |
| Provider Name | Katherine Newberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174282503 PECOS PAC ID: 7719366459 Enrollment ID: I20220627000645 |
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