| Pioneer Family Practice, Pllc | |
|
5130 Corporate Center Ct Se Lacey WA 98503-5957 | |
| (360) 413-8600 | |
| (360) 413-8822 |
| Full Name | Pioneer Family Practice, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5130 Corporate Center Ct Se, Lacey, Washington |
| Authorized Official Name and Position | Diane M Taylor (BUSINESS MANAGER) |
| Authorized Official Contact | 3604138617 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pioneer Family Practice, Pllc 5130 Corporate Center Ct Se Lacey WA 98503-5957 Ph: (360) 413-8600 | Pioneer Family Practice, Pllc 5130 Corporate Center Ct Se Lacey WA 98503-5957 Ph: (360) 413-8600 |
| NPI Number | 1205965365 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 5890766232 |
|---|---|
| Medicare Enrollment ID | O20040802000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205965365 | NPI | - | NPPES |
| 147741 | Other | WA | LABOR AND INUDUSTRY |
| 7105869 | Medicaid | WA | |
| 02 | Other | WA | CORPORATE |
| 1205965365 | Other | WA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jennifer A Playstead |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851464937 PECOS PAC ID: 7416027701 Enrollment ID: I20080529000201 |
| Provider Name | Edward D Cates |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730231127 PECOS PAC ID: 9739236340 Enrollment ID: I20090420000237 |
| Provider Name | Devin R Sawyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497756308 PECOS PAC ID: 1557491990 Enrollment ID: I20100611000457 |
| Provider Name | Cris E Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144390261 PECOS PAC ID: 4183771769 Enrollment ID: I20100803000919 |
| Provider Name | Lucinda A Grande |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982714317 PECOS PAC ID: 6103097001 Enrollment ID: I20110926000917 |
| Provider Name | Yan Geng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104146620 PECOS PAC ID: 7012168990 Enrollment ID: I20150714001783 |
| Provider Name | Heidi Renee Swift |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730551862 PECOS PAC ID: 1850695263 Enrollment ID: I20180919000898 |
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