| Peninsula Family Medical Center | |
|
4700 Point Fosdick Dr Ste 220 Gig Harbor WA 98335-1706 | |
| (253) 851-5121 | |
| (253) 851-3059 |
| Full Name | Peninsula Family Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 4700 Point Fosdick Dr Ste 220, Gig Harbor, Washington |
| Authorized Official Name and Position | Cindy M Hart (BUSINESS MANAGER) |
| Authorized Official Contact | 2538515121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peninsula Family Medical Center 4700 Point Fosdick Dr Ste 220 Gig Harbor WA 98335-1706 Ph: (253) 851-5121 | Peninsula Family Medical Center 4700 Point Fosdick Dr Ste 220 Gig Harbor WA 98335-1706 Ph: (253) 851-5121 |
| NPI Number | 1588674998 |
|---|---|
| Provider Enumeration Date | 08/08/2006 |
| Last Update Date | 06/03/2021 |
| Medicare PECOS PAC ID | 2961399266 |
|---|---|
| Medicare Enrollment ID | O20040302000449 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588674998 | NPI | - | NPPES |
| 7237407 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Erin E Dodge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760403331 PECOS PAC ID: 7113997115 Enrollment ID: I20040728000200 |
| Provider Name | Vincent M Leverett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326058744 PECOS PAC ID: 7214998616 Enrollment ID: I20041019001433 |
| Provider Name | Mathea Helice Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871742635 PECOS PAC ID: 7113070335 Enrollment ID: I20090805000102 |
| Provider Name | Dianna E Avey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740215755 PECOS PAC ID: 2567599194 Enrollment ID: I20100429000900 |
| Provider Name | Christine Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497725733 PECOS PAC ID: 0941494769 Enrollment ID: I20101104001541 |
| Provider Name | Joan E Halley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013994565 PECOS PAC ID: 8527253640 Enrollment ID: I20101115000156 |
| Provider Name | Mark F Craddock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497728901 PECOS PAC ID: 2769677889 Enrollment ID: I20101115000212 |
| Provider Name | Jennifer E Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215919170 PECOS PAC ID: 5496940488 Enrollment ID: I20101116001041 |
| Provider Name | Catherine Shutty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134369911 PECOS PAC ID: 2668877093 Enrollment ID: I20210824001993 |
| Provider Name | Julie Anne Szczepanik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326711391 PECOS PAC ID: 7214332337 Enrollment ID: I20210826002822 |
| Provider Name | Samuel M Shirk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760779698 PECOS PAC ID: 8426373259 Enrollment ID: I20211102001348 |
| Provider Name | Vilma Jeanette Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346929544 PECOS PAC ID: 4688017775 Enrollment ID: I20240206001098 |
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