| Dr Eric D Dant, MD | |
|
850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022-0800 | |
| (509) 565-4000 | |
| (509) 565-4705 |
| Full Name | Dr Eric D Dant |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 850 Maple Street, Medical Lake, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699746404 | NPI | - | NPPES |
| 806187300 | Other | ID | BOUNDARY COMMUNITY HOSP |
| 806187300 | Medicaid | ID | |
| 8147910 | Other | WA | MEDICAID |
| 8147910 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M8280 (Idaho) | Secondary |
| 207Q00000X | Family Medicine | MD00030830 (Washington) | Primary |
| Entity Name | Spokane Behavioral Health Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932698107 PECOS PAC ID: 2961757489 Enrollment ID: O20190117001282 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Eric D Dant, MD Po Box 800, Eastern State Hospital, Medical Lake, WA 99022-0800 Ph: (509) 565-4000 | Dr Eric D Dant, MD 850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022-0800 Ph: (509) 565-4000 |
Dr. Suzanne D. Peregoy, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 850 Maple Street, Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-4705 | |
Dr. Ted Y Toribara, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 800 West Maple Street, Medical Lake, WA 99022 Phone: 509-299-3121 Fax: 509-299-7015 | |
Thomas A. Crisp Jr., D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 850 Maple Street, Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-4705 | |
Steven W. Palmieri, PHD, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 850 Maple Street, Eastern State Hospital, Medical Lake, WA 99022 Phone: 509-565-4000 Fax: 509-565-4705 | |
Douglas R Gwinn, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 725 N Stanley St, Suite D, Medical Lake, WA 99022 Phone: 509-838-2531 | |
Dr. Blesilda A Mamerto, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 800 West Maple Street, Medical Lake, WA 99022 Phone: 509-299-3121 Fax: 509-299-7015 |