| Seattle Indian Health Board | |
|
611 12th Ave S Seattle WA 98144-1910 | |
| (206) 324-9360 | |
| (206) 324-8910 |
| Full Name | Seattle Indian Health Board |
|---|---|
| Speciality | Clinic/Center |
| Location | 611 12th Ave S, Seattle, Washington |
| Authorized Official Name and Position | Eshter Lucero (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2063249360 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seattle Indian Health Board 611 12th Ave S Seattle WA 98144-1910 Ph: (206) 324-9360 | Seattle Indian Health Board 611 12th Ave S Seattle WA 98144-1910 Ph: (206) 324-9360 |
| NPI Number | 1316012461 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 03/12/2021 |
| Medicare PECOS PAC ID | 7517866973 |
|---|---|
| Medicare Enrollment ID | O20040105000550 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316012461 | NPI | - | NPPES |
| 10443673 | Medicaid | WA | |
| 7034226 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Theresa M Maresca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932177664 PECOS PAC ID: 9234127945 Enrollment ID: I20040503000807 |
| Provider Name | Dean E Riskedahl |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396800025 PECOS PAC ID: 7113908492 Enrollment ID: I20040525000562 |
| Provider Name | Alison Hadley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336226562 PECOS PAC ID: 4587645619 Enrollment ID: I20040525001748 |
| Provider Name | Christopher H Gaynor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023085495 PECOS PAC ID: 9931110061 Enrollment ID: I20060605000208 |
| Provider Name | Lisa L Sferra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922038819 PECOS PAC ID: 2860497971 Enrollment ID: I20060925000122 |
| Provider Name | Brianna Tanyi |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407036395 PECOS PAC ID: 3274610787 Enrollment ID: I20080408000855 |
| Provider Name | Jacqueline Y Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184841710 PECOS PAC ID: 2860546306 Enrollment ID: I20090818000199 |
| Provider Name | William Anthony Alto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962478073 PECOS PAC ID: 4183652639 Enrollment ID: I20120106000601 |
| Provider Name | Peter Allan Talbot |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760459143 PECOS PAC ID: 4981861291 Enrollment ID: I20120127000857 |
| Provider Name | Joseph W Ng |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1609958586 PECOS PAC ID: 7517124449 Enrollment ID: I20120206000205 |
| Provider Name | Kimberly J Kardonsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073664454 PECOS PAC ID: 2860580669 Enrollment ID: I20130801000595 |
| Provider Name | Christine P Steele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760814958 PECOS PAC ID: 9931337029 Enrollment ID: I20140117000711 |
| Provider Name | Emily B Ashbaugh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013201979 PECOS PAC ID: 8426275819 Enrollment ID: I20140807002453 |
| Provider Name | Thuy Dan Do |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124336797 PECOS PAC ID: 3476771825 Enrollment ID: I20140826001839 |
| Provider Name | Anuj Khattar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841550712 PECOS PAC ID: 3375863517 Enrollment ID: I20150813012395 |
| Provider Name | David B Sapienza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306106331 PECOS PAC ID: 5496075624 Enrollment ID: I20150817002353 |
| Provider Name | Socia Nicole Love-thurman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356787451 PECOS PAC ID: 7517288772 Enrollment ID: I20160708000718 |
| Provider Name | Simon Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972980811 PECOS PAC ID: 8022302421 Enrollment ID: I20160808002251 |
| Provider Name | Teresa J Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124464151 PECOS PAC ID: 8123349206 Enrollment ID: I20161021001680 |
| Provider Name | Jayne T Gaubatz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669884664 PECOS PAC ID: 6103132055 Enrollment ID: I20170710001444 |
| Provider Name | Hei Wah Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720490790 PECOS PAC ID: 8022323609 Enrollment ID: I20170711000748 |
| Provider Name | Andrea Bachhuber-beam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326450404 PECOS PAC ID: 8426341173 Enrollment ID: I20170828004302 |
| Provider Name | Jamie Tom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497290720 PECOS PAC ID: 3274806054 Enrollment ID: I20170829004204 |
| Provider Name | Pnina Strasbourger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508212200 PECOS PAC ID: 4688949258 Enrollment ID: I20190919001315 |
| Provider Name | Amy Marie Chabitnoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396108957 PECOS PAC ID: 4385078039 Enrollment ID: I20200106000801 |
| Provider Name | Trevor C Dickey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033571211 PECOS PAC ID: 5991098600 Enrollment ID: I20201005002709 |
| Provider Name | Gina Bridgette Perez Baron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275703118 PECOS PAC ID: 3476699794 Enrollment ID: I20201029000443 |
| Provider Name | Peter Conley Creed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487026423 PECOS PAC ID: 0840594883 Enrollment ID: I20201119002380 |
| Provider Name | Maithri Lakshmi Sarangam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245762400 PECOS PAC ID: 1153699236 Enrollment ID: I20210412000998 |
| Provider Name | Melinda Garay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760994370 PECOS PAC ID: 8527477462 Enrollment ID: I20210506000712 |
| Provider Name | Lindsey Ann Arrasmith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588917637 PECOS PAC ID: 4981008752 Enrollment ID: I20210802003260 |
| Provider Name | Elizabeth Parks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760918957 PECOS PAC ID: 3678843315 Enrollment ID: I20210826000414 |
| Provider Name | Kara Ann Harvill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427554229 PECOS PAC ID: 6507117678 Enrollment ID: I20210916002439 |
| Provider Name | Shawna Fay Gallagher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083885818 PECOS PAC ID: 3173911146 Enrollment ID: I20211025000055 |
| Provider Name | Patricia Hobbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760604029 PECOS PAC ID: 1153510391 Enrollment ID: I20220124002112 |
| Provider Name | Lauren Sawyer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1255083168 PECOS PAC ID: 0749672533 Enrollment ID: I20220128001835 |
| Provider Name | Margaret Claire Wilson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1518237684 PECOS PAC ID: 1355720301 Enrollment ID: I20220621003206 |
| Provider Name | Matthew Markey-crimp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366903171 PECOS PAC ID: 3072842764 Enrollment ID: I20220722001652 |
| Provider Name | Janice P Clark |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1811168339 PECOS PAC ID: 3577631613 Enrollment ID: I20230302001408 |
| Provider Name | James Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831540723 PECOS PAC ID: 2062708415 Enrollment ID: I20230320001679 |
| Provider Name | Alexis Lee Brendible |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770111528 PECOS PAC ID: 7618390501 Enrollment ID: I20230707001612 |
| Provider Name | Joshua Doppelt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275161770 PECOS PAC ID: 8628497989 Enrollment ID: I20230821001076 |
| Provider Name | Bridget Stixrood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588439186 PECOS PAC ID: 8628411758 Enrollment ID: I20240206002420 |
Vera Whole Health Wa Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4540 Sand Point Way Ne Ste 100, Seattle, WA 98105 Phone: 206-575-8880 Fax: 206-223-2334 | |
Washington Neurodiagnostics, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 Dexter Ave N Ste 179, Seattle, WA 98109 Phone: 206-866-0076 Fax: 866-279-4704 | |
Rainier Beach Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9245 Rainier Ave S, Seattle, WA 98118 Phone: 206-548-7600 Fax: 206-548-7601 | |
Every Body Moves, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5238 57th Ave S, Seattle, WA 98118 Phone: 206-618-5632 | |
Virginia Mason Medical Center-gastroenterology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 9th Ave, Seattle, WA 98101 Phone: 206-223-6600 | |
Neighborcare Health At Denny International Middle School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2601 Sw Kenyon St, Seattle, WA 98126 Phone: 206-923-2809 Fax: 206-923-2818 | |
Pacific Medical Centers Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 12th Ave S, Seattle, WA 98124 Phone: 206-621-4316 |