Weaver Family Medicine | |
2935 Allen Rd Sunnyside WA 98944-8931 | |
(509) 837-0070 | |
(509) 837-0690 |
Full Name | Weaver Family Medicine |
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Speciality | Family Medicine |
Location | 2935 Allen Rd, Sunnyside, Washington |
Authorized Official Name and Position | Kathy Anderson (OFFICE MANAGER) |
Authorized Official Contact | 5098370070 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Weaver Family Medicine 2935 Allen Rd Sunnyside WA 98944-8931 Ph: (509) 837-0070 | Weaver Family Medicine 2935 Allen Rd Sunnyside WA 98944-8931 Ph: (509) 837-0070 |
NPI Number | 1982081485 |
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Provider Enumeration Date | 05/04/2015 |
Last Update Date | 11/17/2022 |
Medicare PECOS PAC ID | 8123322716 |
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Medicare Enrollment ID | O20160202000515 |
Identifier | Type | State | Issuer |
---|---|---|---|
1982081485 | NPI | - | NPPES |
2045212 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | OP60139736 (Washington) | Primary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
Provider Name | Judith K Harvey |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710901731 PECOS PAC ID: 2163473356 Enrollment ID: I20060320000108 |
Provider Name | Derek S Weaver |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962660704 PECOS PAC ID: 8325220098 Enrollment ID: I20150617000232 |
Provider Name | Paul A Shoemaker |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053654913 PECOS PAC ID: 5496094146 Enrollment ID: I20190225002398 |
Provider Name | Corryn Elizabeth Koopmans |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538883699 PECOS PAC ID: 7517337645 Enrollment ID: I20230105001058 |
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