| Warm Springs Health And Wellness Dhhs Ihs Warm Springs Service Unit | |
|
1270 Kot Num Rd Warm Springs OR 97761 | |
| (541) 553-1196 | |
| (541) 553-2135 |
| Full Name | Warm Springs Health And Wellness Dhhs Ihs Warm Springs Service Unit |
|---|---|
| Speciality | Clinic/Center |
| Location | 1270 Kot Num Rd, Warm Springs, Oregon |
| Authorized Official Name and Position | Carol Prevost (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5415531196 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Warm Springs Health And Wellness Dhhs Ihs Warm Springs Service Unit 1270 Kot Num Rd Warm Springs OR 97761 Ph: (541) 553-1196 | Warm Springs Health And Wellness Dhhs Ihs Warm Springs Service Unit 1270 Kot Num Rd Warm Springs OR 97761 Ph: (541) 553-1196 |
| NPI Number | 1417084708 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 06/23/2011 |
| Medicare PECOS PAC ID | 2668490970 |
|---|---|
| Medicare Enrollment ID | O20051104000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417084708 | NPI | - | NPPES |
| 273855 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Rachel E Locker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427160878 PECOS PAC ID: 3577581792 Enrollment ID: I20051107000444 |
| Provider Name | Thomas J Creelman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194717017 PECOS PAC ID: 0244258465 Enrollment ID: I20051107000516 |
| Provider Name | Stephen Miles Rudd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952303273 PECOS PAC ID: 6507884731 Enrollment ID: I20051107000538 |
| Provider Name | Christopher W Keane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265431449 PECOS PAC ID: 0244240489 Enrollment ID: I20060502000589 |
| Provider Name | Jon C Stucki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235236126 PECOS PAC ID: 5890876841 Enrollment ID: I20080115000738 |
| Provider Name | Joseph P Santiago |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285667188 PECOS PAC ID: 1153466214 Enrollment ID: I20100301000959 |
| Provider Name | Hai Tuan Tran |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1982690954 PECOS PAC ID: 7517995616 Enrollment ID: I20170104000586 |
| Provider Name | Marc W Levin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235131749 PECOS PAC ID: 1951291293 Enrollment ID: I20171219002534 |
| Provider Name | Yvonne C Stevenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124084181 PECOS PAC ID: 5799922324 Enrollment ID: I20181023000099 |
| Provider Name | Marcel M Tam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083978472 PECOS PAC ID: 4183841034 Enrollment ID: I20190102000522 |
| Provider Name | Corinne E Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427513837 PECOS PAC ID: 0446583868 Enrollment ID: I20200130001332 |
| Provider Name | Melissa L Devalon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457327025 PECOS PAC ID: 8325210974 Enrollment ID: I20200331001381 |
| Provider Name | Emily M Karben |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174875413 PECOS PAC ID: 2769797737 Enrollment ID: I20230328002867 |
Warm Springs Health And Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Kot-num Road, Warm Springs, OR 97761 Phone: 541-553-2134 Fax: 541-553-2481 | |
Warm Springs Health And Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Kot-num Road, Warm Springs, OR 97761 Phone: 541-553-1196 Fax: 541-553-2135 | |
Confederated Tribes Of The Warm Springs Reservation Of Oregon Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Kot Num Rd, Warm Springs, OR 97761 Phone: 541-553-1196 | |
Warm Springs Health And Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Kot Num Road, Warm Springs, OR 97761 Phone: 541-553-1196 Fax: 541-553-2613 | |
Warm Springs Health And Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Kot-num Road, Warm Springs, OR 97761 Phone: 541-553-1196 Fax: 541-553-1130 | |
Confederated Tribes Of The Warm Springs Reservation Of Oregon Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1115 Wasco Street, Warm Springs, OR 97761 Phone: 541-553-3205 Fax: 541-553-4900 |