Dr Thomas James Luetkehans, MD | |
3417 Ensign Rd Ne, Olympia, WA 98506-5075 | |
(360) 493-4609 | |
(360) 493-4603 |
Full Name | Dr Thomas James Luetkehans |
---|---|
Gender | Male |
Speciality | Radiology - Vascular & Interventional Radiology |
Location | 3417 Ensign Rd Ne, Olympia, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821089160 | NPI | - | NPPES |
078229 | Other | WA | L&I-SOUTH SOUND RADIOLOGY |
8137457 | Medicaid | WA | |
1045797 | Medicaid | WA | |
0384820 | Other | WA | L&I-RADIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | MD00029619 (Washington) | Secondary |
2085R0204X | Radiology - Vascular & Interventional Radiology | MD00029619 (Washington) | Primary |
Entity Name | Radia Inc P S |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932196607 PECOS PAC ID: 9931012812 Enrollment ID: O20031106000749 |
Entity Name | Evergreen Radia Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922095694 PECOS PAC ID: 4587568076 Enrollment ID: O20031125000896 |
Entity Name | Swedish Radia Imaging Center At Edmonds Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164494373 PECOS PAC ID: 5496778292 Enrollment ID: O20060106000841 |
Entity Name | Radia Imaging Center Holdings Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639653017 PECOS PAC ID: 6305182965 Enrollment ID: O20190118000572 |
Mailing Address | Practice Location Address |
---|---|
Dr Thomas James Luetkehans, MD 19020 33rd Ave W Ste 210, Lynnwood, WA 98036-4748 Ph: (425) 563-1500 | Dr Thomas James Luetkehans, MD 3417 Ensign Rd Ne, Olympia, WA 98506-5075 Ph: (360) 493-4609 |
Dr. Kevin Joseph Reed, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3417 Ensign Rd Ne, Olympia, WA 98506 Phone: 360-493-4609 Fax: 360-493-4603 | |
Dr. Lawrence Northwood Bennett, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3417 Ensign Rd Ne, Olympia, WA 98506 Phone: 360-493-4600 Fax: 360-493-4603 | |
Dr. Samuel J. Boynton, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3417 Ensign Rd Ne, Olympia, WA 98506 Phone: 360-493-4600 Fax: 360-493-4603 | |
Dr. Tariq Hesham Balawi, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3417 Ensign Rd Ne, Olympia, WA 98506 Phone: 360-493-4600 Fax: 360-493-4603 | |
Dr. Jabi Elijah Shriki, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3417 Ensign Road Ne, Olympia, WA 98506 Phone: 360-493-4609 Fax: 360-493-4603 | |
Dr. Jack Mark Fields, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3417 Ensign Rd Ne, Olympia, WA 98506 Phone: 360-493-4600 Fax: 360-493-4603 | |
Dr. Christopher Brinson Hartness, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 413 Lilly Rd Ne, Olympia, WA 98506 Phone: 604-937-4603 Fax: 360-493-7253 |