Wellington Provider Group Pc | |
1455 Nw Leary Way Ste 400 Seattle WA 98107-5138 | |
(859) 439-0400 | |
Not Available |
Full Name | Wellington Provider Group Pc |
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Speciality | General Practice |
Location | 1455 Nw Leary Way Ste 400, Seattle, Washington |
Authorized Official Name and Position | Brittany Dennis (CREDENTIALING MANGER) |
Authorized Official Contact | 8595188817 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wellington Provider Group Pc 535 Wellington Way Ste 330 Lexington KY 40503-1331 Ph: () - | Wellington Provider Group Pc 1455 Nw Leary Way Ste 400 Seattle WA 98107-5138 Ph: (859) 439-0400 |
NPI Number | 1336859826 |
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Provider Enumeration Date | 11/25/2022 |
Last Update Date | 11/25/2022 |
Medicare PECOS PAC ID | 8123412459 |
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Medicare Enrollment ID | O20221227000680 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336859826 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Michael Stone |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1043201262 PECOS PAC ID: 0143275016 Enrollment ID: I20161118000707 |
Provider Name | Carl Seger |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1699957308 PECOS PAC ID: 1951455773 Enrollment ID: I20230123000512 |
Provider Name | Jeremy Stich |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295027126 PECOS PAC ID: 7416133616 Enrollment ID: I20230201001732 |
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