| Dr Joel D Hernandez, MD | |
|
101 W 8th Ave, Ste. 100, L-1, Spokane, WA 99204-2307 | |
| (509) 232-1192 | |
| (509) 232-1165 |
| Full Name | Dr Joel D Hernandez |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Pediatric Nephrology |
| Location | 101 W 8th Ave, Spokane, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760516462 | NPI | - | NPPES |
| GAB32999 | Other | WA | MEDICARE GROUP |
| 807680300 | Other | WA | IDAHO MEDICAID |
| 8480683 | Other | WA | WA MEDICAID |
| G8864785 | Other | WA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0210X | Pediatrics - Pediatric Nephrology | MD00047205 (Washington) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Joel D Hernandez, MD 910 N Washington St, Ste. 209, Spokane, WA 99201-2202 Ph: (509) 232-1192 | Dr Joel D Hernandez, MD 101 W 8th Ave, Ste. 100, L-1, Spokane, WA 99204-2307 Ph: (509) 232-1192 |
Robert E Piston, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6002 N Lidgerwood St, Spokane, WA 99208 Phone: 509-482-4402 Fax: 509-483-7631 | |
Dr. Tanisha Kamille Morton, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 6002 N Lidgerwood St, Spokane, WA 99208 Phone: 509-482-4402 | |
Carolanne Lyons, Pediatrics Medicare: Medicare Enrolled Practice Location: 1402 S Grand Blvd, Spokane, WA 99203 Phone: 509-455-8220 Fax: 509-455-9172 | |
Sarah E D'hulst, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 400 E 5th Ave, Spokane, WA 99202 Phone: 509-838-2531 | |
Dr. Joseph Paul Kincaid, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 408 W 25th Ave, Spokane, WA 99203 Phone: 509-999-8237 | |
Carrie Elizabeth Laborde, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 101 W 8th Ave Fl 3, Spokane, WA 99204 Phone: 509-474-2777 Fax: 509-474-6222 | |
Dr. David Ross Goshorn, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 101 W 8th Ave, Pshmc 3rd Flr, Spokane, WA 99204 Phone: 509-474-2277 |