| Damilola Ewonubari Olupona, DO | |
|
338 6th St Ste 101, Lewiston, ID 83501-2420 | |
| (208) 848-8300 | |
| (208) 848-8303 |
| Full Name | Damilola Ewonubari Olupona |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 338 6th St Ste 101, Lewiston, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477864932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | O-0716 (Idaho) | Primary |
| 207Q00000X | Family Medicine | OP60328681 (Washington) | Secondary |
| Entity Name | Kaiser Foundation Health Plan Of The Northwest |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040220000099 |
| Mailing Address | Practice Location Address |
|---|---|
| Damilola Ewonubari Olupona, DO 203 N Washington St Ste 300, Spokane, WA 99201-0254 Ph: (509) 444-8888 | Damilola Ewonubari Olupona, DO 338 6th St Ste 101, Lewiston, ID 83501-2420 Ph: (208) 848-8300 |
Dr. Christina R Bjornstad, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 625 6th Ave, Lewiston, ID 83501 Phone: 208-743-8226 Fax: 208-746-2069 | |
Larry Dean Harries, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 307 St Johns Way, Ste 4, Lewiston, ID 83501 Phone: 208-743-8585 Fax: 208-743-0118 | |
Dr. Christine C Schaller, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2315 8th St, Lewiston, ID 83501 Phone: 208-983-5120 Fax: 208-983-5404 | |
Dr. Donald J Greggain, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 415 6th St Ste 3c, Lewiston, ID 83501 Phone: 208-750-3840 Fax: 208-750-3839 | |
Dr. Garrett Alan Mockler, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2841 Juniper Dr, Lewiston, ID 83501 Phone: 208-848-9001 Fax: 208-848-9002 | |
Glenn E Jefferson Jr., MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2315 8th St, Lewiston, ID 83501 Phone: 208-746-1383 Fax: 208-746-6348 | |
Cheryl A Mallory, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2315 8th St, Lewiston, ID 83501 Phone: 208-746-1383 Fax: 208-746-6348 |