| Wallace Gibbons, MD | |
|
820 N Chelan Ave, Wenatchee, WA 98801-2028 | |
| (509) 663-8711 | |
| Not Available |
| Full Name | Wallace Gibbons |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Location | 820 N Chelan Ave, Wenatchee, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932134244 | NPI | - | NPPES |
| P01256576 | Other | WA | RR MEDICARE |
| 1932134244 | Medicaid | WA | |
| 31238 | Other | WA | L&I |
| 315977 | Other | WA | L&I POST 7/21/13 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | MD00024544 (Washington) | Primary |
| Entity Name | Central Washington Health Services Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801937453 PECOS PAC ID: 4880504596 Enrollment ID: O20031106000287 |
| Entity Name | Wenatchee Valley Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669719688 PECOS PAC ID: 9537309869 Enrollment ID: O20130716000034 |
| Mailing Address | Practice Location Address |
|---|---|
| Wallace Gibbons, MD 820 N Chelan Ave, Wenatchee, WA 98801-2028 Ph: () - | Wallace Gibbons, MD 820 N Chelan Ave, Wenatchee, WA 98801-2028 Ph: (509) 663-8711 |
Travis M Clark, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 820 N Chelan Ave, Wenatchee, WA 98801 Phone: 509-663-8711 | |
Dr. Cheryl S Shih, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 820 N Chelan Ave, Wenatchee, WA 98801 Phone: 509-663-8711 | |
Ian Mclaren, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 820 N Chelan Ave, Wenatchee, WA 98801 Phone: 509-663-8711 | |
Dale T Peterson, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 820 N Chelan Ave, Wenatchee, WA 98801 Phone: 509-663-8711 | |
Brent Alexander Knight, Urology Medicare: Accepting Medicare Assignments Practice Location: 820 N Chelan Ave, Wenatchee, WA 98801 Phone: 509-663-8711 | |
James Mansel Harris, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 820 N Chelan Ave, Wenatchee, WA 98801 Phone: 509-663-8711 | |
Jeffrey M Monda, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 820 N Chelan Ave, Wenatchee, WA 98801 Phone: 509-663-8711 |