| Samaritan Clinic | |
|
1550 S Pioneer Way Ste 115 Moses Lake WA 98837-4618 | |
| (509) 793-9713 | |
| (509) 764-3244 |
| Full Name | Samaritan Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1550 S Pioneer Way Ste 115, Moses Lake, Washington |
| Authorized Official Name and Position | Theresa Sullivan (CEO) |
| Authorized Official Contact | 5097939710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Samaritan Clinic 660 S Coolidge St Moses Lake WA 98837-1872 Ph: (509) 793-9715 | Samaritan Clinic 1550 S Pioneer Way Ste 115 Moses Lake WA 98837-4618 Ph: (509) 793-9713 |
| NPI Number | 1619086766 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 12/28/2020 |
| Medicare PECOS PAC ID | 9931095692 |
|---|---|
| Medicare Enrollment ID | O20040227000602 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619086766 | NPI | - | NPPES |
| 1014658 | Medicaid | WA | |
| 7063415 | Medicaid | WA | |
| 7109929 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Eric J Bowton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538169446 PECOS PAC ID: 1759280399 Enrollment ID: I20040122000934 |
| Provider Name | Christiian T Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568454999 PECOS PAC ID: 8224018783 Enrollment ID: I20040723001020 |
| Provider Name | Geoffrey L Tyson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679610778 PECOS PAC ID: 1456318732 Enrollment ID: I20041217000844 |
| Provider Name | Kimberlee F Poole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275539256 PECOS PAC ID: 1557300084 Enrollment ID: I20050425001198 |
| Provider Name | Ian C Doten |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457382806 PECOS PAC ID: 9436191590 Enrollment ID: I20050531000065 |
| Provider Name | Harold R Goldberg |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1497779334 PECOS PAC ID: 4486669496 Enrollment ID: I20060213000516 |
| Provider Name | Vanessa Ratcliff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215961404 PECOS PAC ID: 7517962277 Enrollment ID: I20061002000456 |
| Provider Name | Brian N Nordstrom |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518992858 PECOS PAC ID: 1254340599 Enrollment ID: I20070920000122 |
| Provider Name | Kent B Gustin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659551612 PECOS PAC ID: 6709969900 Enrollment ID: I20080212000062 |
| Provider Name | Kimberly L Mckay |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598773400 PECOS PAC ID: 9537165451 Enrollment ID: I20080425000118 |
| Provider Name | Brett R Degooyer |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1568477354 PECOS PAC ID: 9234231937 Enrollment ID: I20090624000110 |
| Provider Name | John G Peterson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1013931997 PECOS PAC ID: 2769572445 Enrollment ID: I20091027000207 |
| Provider Name | Thomas R Tuszynski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952325474 PECOS PAC ID: 1850430380 Enrollment ID: I20091123000355 |
| Provider Name | Andrea M Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770595282 PECOS PAC ID: 8325171499 Enrollment ID: I20100727000645 |
| Provider Name | Trisha Wasci Kruger |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1639396930 PECOS PAC ID: 8224223334 Enrollment ID: I20101115001298 |
| Provider Name | Jennifer M Lee |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922201581 PECOS PAC ID: 8123298908 Enrollment ID: I20110906000116 |
| Provider Name | M L Dieter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508857103 PECOS PAC ID: 2062552839 Enrollment ID: I20120105000734 |
| Provider Name | Angela Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932478641 PECOS PAC ID: 2466614193 Enrollment ID: I20120425000690 |
| Provider Name | Billie J Scott |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518206390 PECOS PAC ID: 5193730158 Enrollment ID: I20130311000528 |
| Provider Name | Stephanie Moore |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093050916 PECOS PAC ID: 0749435071 Enrollment ID: I20130312000341 |
| Provider Name | Paul E Miller |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992744106 PECOS PAC ID: 5395744650 Enrollment ID: I20130312000419 |
| Provider Name | Spencer W Soffe |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104166206 PECOS PAC ID: 5597901462 Enrollment ID: I20130419000148 |
| Provider Name | Naveen Rawat |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801137716 PECOS PAC ID: 4183864986 Enrollment ID: I20130627000597 |
| Provider Name | Olumide Olagunju |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285958884 PECOS PAC ID: 2365685757 Enrollment ID: I20130904000707 |
| Provider Name | Bhupesh Ratansingh Rathod |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699077263 PECOS PAC ID: 8325225949 Enrollment ID: I20140220000505 |
| Provider Name | Jonathan L Ingram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336557867 PECOS PAC ID: 1355568528 Enrollment ID: I20140812000842 |
| Provider Name | Bo J Beus |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477842268 PECOS PAC ID: 9335388354 Enrollment ID: I20140829002311 |
| Provider Name | Daniel Garrison Crosby |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588086722 PECOS PAC ID: 0244451367 Enrollment ID: I20141020002377 |
| Provider Name | Aaron M Eastman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215351713 PECOS PAC ID: 2466675756 Enrollment ID: I20141216000389 |
| Provider Name | Ryan Rasmussen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780974451 PECOS PAC ID: 5294055323 Enrollment ID: I20150513001286 |
| Provider Name | Teresa Hutsell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710927348 PECOS PAC ID: 3870804222 Enrollment ID: I20150625002084 |
| Provider Name | Micaela Theisen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902158421 PECOS PAC ID: 9830342369 Enrollment ID: I20150820010016 |
| Provider Name | Jeremy B Perry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053590026 PECOS PAC ID: 9830289859 Enrollment ID: I20150917002807 |
| Provider Name | Hsien Sing Sam Hsieh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265745392 PECOS PAC ID: 5799093480 Enrollment ID: I20150929003181 |
| Provider Name | Leo Y Chough |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1053397901 PECOS PAC ID: 2860391620 Enrollment ID: I20151208002733 |
| Provider Name | Scott L Truman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811290760 PECOS PAC ID: 6507041449 Enrollment ID: I20160222001088 |
| Provider Name | Matthew Lockwood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558420067 PECOS PAC ID: 8224076765 Enrollment ID: I20160405001581 |
| Provider Name | Ryan P Perry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831548759 PECOS PAC ID: 9133410749 Enrollment ID: I20160628002553 |
| Provider Name | Jana R Mullen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043291115 PECOS PAC ID: 8022134329 Enrollment ID: I20160830001167 |
| Provider Name | Amelie Peryea |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538427067 PECOS PAC ID: 7719296458 Enrollment ID: I20170306002296 |
| Provider Name | Carissa L Armstrong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144668005 PECOS PAC ID: 4486935483 Enrollment ID: I20170619002681 |
| Provider Name | Richard A Eck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801282561 PECOS PAC ID: 1658688627 Enrollment ID: I20171027001504 |
| Provider Name | Arezou Amidi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1992144398 PECOS PAC ID: 9830493147 Enrollment ID: I20171116002498 |
| Provider Name | Derek C Mitchell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437425535 PECOS PAC ID: 5890074702 Enrollment ID: I20180207002305 |
| Provider Name | Daniel Slack |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780098442 PECOS PAC ID: 0648497313 Enrollment ID: I20180208001233 |
| Provider Name | Robert Dustin Bulloch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982000451 PECOS PAC ID: 8729303029 Enrollment ID: I20180419001651 |
| Provider Name | Elizabeth M Bonadies |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1235637414 PECOS PAC ID: 7810250982 Enrollment ID: I20180424002672 |
| Provider Name | Quinton M Hatch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215255088 PECOS PAC ID: 9436471174 Enrollment ID: I20180614002585 |
| Provider Name | Monica J Mann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952550329 PECOS PAC ID: 2062714207 Enrollment ID: I20180920000572 |
| Provider Name | Taylor Kurt Haberman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922580877 PECOS PAC ID: 9739424052 Enrollment ID: I20181214000628 |
| Provider Name | Pranav Upendra Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861873804 PECOS PAC ID: 6103138631 Enrollment ID: I20190222000758 |
| Provider Name | Kara E Sawyer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689092561 PECOS PAC ID: 5496036576 Enrollment ID: I20190715002858 |
| Provider Name | Paul B Warfield |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841206422 PECOS PAC ID: 6901908813 Enrollment ID: I20191210002292 |
| Provider Name | Charlie D Beaupied |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780047738 PECOS PAC ID: 9335430834 Enrollment ID: I20191216001740 |
| Provider Name | Jason Furbee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407277130 PECOS PAC ID: 4385967348 Enrollment ID: I20200306001914 |
| Provider Name | Elosia Sarah Furbee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124427083 PECOS PAC ID: 7810215308 Enrollment ID: I20200330003504 |
| Provider Name | Bradley Preston Goll |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770121089 PECOS PAC ID: 3476982794 Enrollment ID: I20200407001733 |
| Provider Name | Ronnie Wing |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013974369 PECOS PAC ID: 6103892013 Enrollment ID: I20200807000122 |
| Provider Name | Stephen R Noorlander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790214500 PECOS PAC ID: 6901175611 Enrollment ID: I20200810003724 |
| Provider Name | Michael V Parmley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245674043 PECOS PAC ID: 3072740893 Enrollment ID: I20200812000316 |
| Provider Name | Ryan J Ballard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780247320 PECOS PAC ID: 3971846262 Enrollment ID: I20210114001663 |
| Provider Name | Hayley M Heesemann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003329566 PECOS PAC ID: 7315279130 Enrollment ID: I20210121000683 |
| Provider Name | Hillary N Dorsey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477159747 PECOS PAC ID: 1254746779 Enrollment ID: I20210216001102 |
| Provider Name | Stuart S Haigler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205892882 PECOS PAC ID: 0446274765 Enrollment ID: I20210420002630 |
| Provider Name | Brittany E Kesten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942776695 PECOS PAC ID: 0244575249 Enrollment ID: I20210421001110 |
| Provider Name | Calle A Gonzales-bagdon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447360359 PECOS PAC ID: 5991987919 Enrollment ID: I20210427002669 |
| Provider Name | Lisa Cathleen Kieneker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215422928 PECOS PAC ID: 7719235480 Enrollment ID: I20210729003108 |
| Provider Name | Zachary R Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821590415 PECOS PAC ID: 5597169623 Enrollment ID: I20210811001102 |
| Provider Name | Marissa B Anderson-chernishof |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235549957 PECOS PAC ID: 7315342052 Enrollment ID: I20210818003994 |
| Provider Name | Erik A Arnits |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922534437 PECOS PAC ID: 6901177351 Enrollment ID: I20210907003419 |
| Provider Name | Jordan D Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023464609 PECOS PAC ID: 9133525504 Enrollment ID: I20210909003418 |
| Provider Name | Caroline W Hannon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194220848 PECOS PAC ID: 1052668530 Enrollment ID: I20210916003239 |
| Provider Name | Yuttana Chawengsub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518306570 PECOS PAC ID: 7618190968 Enrollment ID: I20211025000895 |
| Provider Name | Ahmad Zabad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780021774 PECOS PAC ID: 9638460306 Enrollment ID: I20211213001053 |
| Provider Name | Madhusudhan Tarigopula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235340621 PECOS PAC ID: 5890880371 Enrollment ID: I20220104001560 |
| Provider Name | Raheel Khalid |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962843979 PECOS PAC ID: 0547556201 Enrollment ID: I20220131001020 |
| Provider Name | Tricia Ginger Stevens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750043584 PECOS PAC ID: 4183018898 Enrollment ID: I20220223000751 |
| Provider Name | Andrea Matson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487031753 PECOS PAC ID: 3173946522 Enrollment ID: I20220225000257 |
| Provider Name | James Edward Bolland |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174905475 PECOS PAC ID: 7911292487 Enrollment ID: I20220329001634 |
| Provider Name | Mark R Bennett |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871955435 PECOS PAC ID: 6608124367 Enrollment ID: I20220517001258 |
| Provider Name | Chinonye Uzaoamaka Nwoke |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245662139 PECOS PAC ID: 9234432089 Enrollment ID: I20220701001706 |
| Provider Name | Varvara Ladage |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871098772 PECOS PAC ID: 2062760671 Enrollment ID: I20220804001235 |
| Provider Name | Akinbode S Egbelakin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104117522 PECOS PAC ID: 3577780626 Enrollment ID: I20220804002744 |
| Provider Name | Sridivya Kosuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578023065 PECOS PAC ID: 0143603985 Enrollment ID: I20220811002769 |
| Provider Name | Alicia Korona |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821470386 PECOS PAC ID: 5890088702 Enrollment ID: I20220818000546 |
| Provider Name | Joseph Muller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376801928 PECOS PAC ID: 7719248483 Enrollment ID: I20220919002290 |
| Provider Name | Peyton J Lane |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013674498 PECOS PAC ID: 8729464458 Enrollment ID: I20221004002987 |
| Provider Name | Billy Albertson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861669384 PECOS PAC ID: 5698846533 Enrollment ID: I20221107002707 |
| Provider Name | Galen Pizzorno |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881199370 PECOS PAC ID: 4981954229 Enrollment ID: I20221202002311 |
| Provider Name | Sheila Wilkey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174833834 PECOS PAC ID: 6608045216 Enrollment ID: I20221216002571 |
| Provider Name | Mwaffak Bashir |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154965622 PECOS PAC ID: 2567832728 Enrollment ID: I20230104000814 |
| Provider Name | Eric B Herbert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497727598 PECOS PAC ID: 0446272652 Enrollment ID: I20230106000475 |
| Provider Name | Danielle Wallace |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114147006 PECOS PAC ID: 7618020611 Enrollment ID: I20230208002252 |
| Provider Name | Sharon Eskam |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629095310 PECOS PAC ID: 1153379367 Enrollment ID: I20230209001180 |
| Provider Name | Pamela Dae Dick |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1598947368 PECOS PAC ID: 1658743661 Enrollment ID: I20230220002040 |
| Provider Name | Jake Leff Wilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700203023 PECOS PAC ID: 8022374560 Enrollment ID: I20230327002807 |
| Provider Name | Zorina Ava Curry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164137139 PECOS PAC ID: 5092189225 Enrollment ID: I20230329002255 |
| Provider Name | Kameron Reza Firouzi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437511276 PECOS PAC ID: 1951724434 Enrollment ID: I20230420002249 |
| Provider Name | Naomasa Hase |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841610961 PECOS PAC ID: 5496053464 Enrollment ID: I20230609002325 |
| Provider Name | Antonio Rosa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548335854 PECOS PAC ID: 2365822046 Enrollment ID: I20230707000344 |
| Provider Name | Karl Matthew Baird |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689646663 PECOS PAC ID: 5193782381 Enrollment ID: I20230707001200 |
| Provider Name | James Brian Haering |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679664775 PECOS PAC ID: 5597656454 Enrollment ID: I20230707001431 |
| Provider Name | Zachary Tan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013438779 PECOS PAC ID: 5799035655 Enrollment ID: I20230717003222 |
| Provider Name | Brandee Black |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477864429 PECOS PAC ID: 5698919959 Enrollment ID: I20230720000732 |
| Provider Name | Jared Wortham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902241235 PECOS PAC ID: 1759675341 Enrollment ID: I20230822001484 |
| Provider Name | Curtis J Papenfuss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891258331 PECOS PAC ID: 2365779105 Enrollment ID: I20230823003797 |
| Provider Name | Carter Newey |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1316409006 PECOS PAC ID: 8527467059 Enrollment ID: I20230824000948 |
| Provider Name | Alexander Alide Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245851971 PECOS PAC ID: 0941621726 Enrollment ID: I20230828002913 |
| Provider Name | Emily Fairbanks |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1760164024 PECOS PAC ID: 0547624611 Enrollment ID: I20230908001362 |
| Provider Name | Jessica Daigle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922397413 PECOS PAC ID: 3375849003 Enrollment ID: I20231002000253 |
| Provider Name | Timothy Leupp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760760474 PECOS PAC ID: 3072749068 Enrollment ID: I20231031002997 |
| Provider Name | Jonathan Wade |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689146128 PECOS PAC ID: 6608114053 Enrollment ID: I20231110002420 |
| Provider Name | Andrew Roth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790787521 PECOS PAC ID: 2163614017 Enrollment ID: I20231128000690 |
| Provider Name | Joshua A Nunnery |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366752198 PECOS PAC ID: 9335337112 Enrollment ID: I20231222002906 |
| Provider Name | Colin Berry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235168642 PECOS PAC ID: 6305803842 Enrollment ID: I20231229002004 |
| Provider Name | Alexis Rogers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952863086 PECOS PAC ID: 8820326663 Enrollment ID: I20240105001187 |
| Provider Name | Shawn Johnson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609927342 PECOS PAC ID: 4284809864 Enrollment ID: I20240110004645 |
| Provider Name | Ignacio Fabian Gonzales |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093742595 PECOS PAC ID: 3375994627 Enrollment ID: I20240110004828 |
| Provider Name | Andrew Hild |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710542261 PECOS PAC ID: 4981932720 Enrollment ID: I20240116003334 |
| Provider Name | Elizabeth Walker-lindgren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568838019 PECOS PAC ID: 2668824814 Enrollment ID: I20240123004158 |
| Provider Name | Miguel Angel De La Mora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821874462 PECOS PAC ID: 4486097151 Enrollment ID: I20240209000617 |
| Provider Name | Benjamin Krasin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316327927 PECOS PAC ID: 0547572000 Enrollment ID: I20240221000619 |
| Provider Name | Rachelle Rigaud |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730648619 PECOS PAC ID: 1254661093 Enrollment ID: I20240228003524 |
| Provider Name | Geralda Andrea James-posey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659734119 PECOS PAC ID: 2365741931 Enrollment ID: I20240403004372 |
| Provider Name | Jackson J Bell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396208070 PECOS PAC ID: 9335470673 Enrollment ID: I20240425000860 |
Healthsource Of Moses Lake Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 W 3rd Ave, Moses Lake, WA 98837 Phone: 509-765-0638 Fax: 509-765-3891 | |
Moses Lake Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 S Coolidge St, Moses Lake, WA 98837 Phone: 509-764-0674 Fax: 509-764-0344 | |
Omni Staffing Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1530 Pilgrim St, Moses Lake, WA 98837 Phone: 509-855-5497 Fax: 509-639-7063 | |
Parkview Pediatrics Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 S Division St, Moses Lake, WA 98837 Phone: 509-766-9450 Fax: 509-766-1954 | |
Pacific Rehabilitation Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 E Broadway Ave Ste 11, Moses Lake, WA 98837 Phone: 425-513-8509 Fax: 425-290-9774 | |
Moses Lake Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 S Coolidge St, Moses Lake, WA 98837 Phone: 509-765-0674 Fax: 509-765-6591 | |
Aion Womens Health Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1022 S Pioneer Way Ste A, Moses Lake, WA 98837 Phone: 509-762-2466 Fax: 509-762-2465 |