Urgent Medical Center Ps | |
9430 Ne Vancouver Mall Dr Vancouver WA 98662-6172 | |
(360) 253-6947 | |
Not Available |
Full Name | Urgent Medical Center Ps |
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Speciality | Family Medicine |
Location | 9430 Ne Vancouver Mall Dr, Vancouver, Washington |
Authorized Official Name and Position | Dean Barrus (PRESIDENT) |
Authorized Official Contact | 3602536947 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Urgent Medical Center Ps 9430 Ne Vancouver Mall Dr Vancouver WA 98662-6172 Ph: (360) 253-6947 | Urgent Medical Center Ps 9430 Ne Vancouver Mall Dr Vancouver WA 98662-6172 Ph: (360) 253-6947 |
NPI Number | 1740321553 |
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Provider Enumeration Date | 02/12/2007 |
Last Update Date | 04/25/2014 |
Medicare PECOS PAC ID | 0446157457 |
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Medicare Enrollment ID | O20031217000897 |
Identifier | Type | State | Issuer |
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1740321553 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 601732598 (Washington) | Primary |
Provider Name | Fernando D Proano |
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Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1750363214 PECOS PAC ID: 9537068010 Enrollment ID: I20040105000022 |
Provider Name | Valerie Smith |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1134313802 PECOS PAC ID: 3678742632 Enrollment ID: I20140320002130 |
Provider Name | Patricia A Moran |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912937483 PECOS PAC ID: 3779476064 Enrollment ID: I20141028000074 |
Provider Name | Charles Tannert Pinney |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1902819451 PECOS PAC ID: 2163511809 Enrollment ID: I20160204000471 |
Provider Name | Glen R Stream |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609068899 PECOS PAC ID: 0042509747 Enrollment ID: I20160519001462 |
Provider Name | Liesel M K Tower |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881053320 PECOS PAC ID: 7618274598 Enrollment ID: I20170918001992 |
Provider Name | Bertram W Berney |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1245455179 PECOS PAC ID: 9133193097 Enrollment ID: I20181211003356 |
Provider Name | Vyacheslav Belous |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154636645 PECOS PAC ID: 2365757218 Enrollment ID: I20221103003277 |
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