| Brad R Mackinnon, MD | |
|
1400 Pottery Ave, Group Health, Port Orchard, WA 98366-3711 | |
| (360) 895-5000 | |
| (360) 895-5558 |
| Full Name | Brad R Mackinnon |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1400 Pottery Ave, Port Orchard, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851529952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD60111450 (Washington) | Primary |
| Entity Name | Kaiser Foundation Health Plan Of Washington |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396810701 PECOS PAC ID: 9032022579 Enrollment ID: O20031112000454 |
| Mailing Address | Practice Location Address |
|---|---|
| Brad R Mackinnon, MD 1400 Pottery Ave, Port Orchard, WA 98366-3711 Ph: (360) 895-5000 | Brad R Mackinnon, MD 1400 Pottery Ave, Group Health, Port Orchard, WA 98366-3711 Ph: (360) 895-5000 |
Ifesinachi S Oguakwa, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 450 So Kitsap Blvd, Suite 100, Port Orchard, WA 98366 Phone: 360-744-6275 Fax: 360-744-6270 | |
Melissa Ayn Meyer, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1141 Beach Dr E, Port Orchard, WA 98366 Phone: 360-895-4680 Fax: 360-895-4709 | |
Daniel Eldredge Diamond, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 450 S Kitsap Blvd, Suite 100, Port Orchard, WA 98366 Phone: 360-744-6275 Fax: 360-744-6270 | |
Christine Agbayani Lomotan, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1400 Pottery Ave, Port Orchard, WA 98366 Phone: 360-895-5000 | |
Robert R Rankin, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 450 So. Kitsap Blvd., Suite 100, Port Orchard, WA 98366 Phone: 360-744-6275 Fax: 360-744-6188 | |
Emily Assavapisitkul, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1400 Pottery Ave, Port Orchard, WA 98366 Phone: 360-895-5000 Fax: 877-516-9023 | |
Richard J. Tanaka, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1400 Pottery Ave, Port Orchard, WA 98366 Phone: 360-895-5000 |