| Coos Health And Wellness | |
|
281 Laclair Street Coos Bay OR 97420 | |
| (541) 266-6700 | |
| (541) 888-8726 |
| Full Name | Coos Health And Wellness |
|---|---|
| Speciality | Clinic/Center |
| Location | 281 Laclair Street, Coos Bay, Oregon |
| Authorized Official Name and Position | Mike K Rowley (CHW DIRECTOR) |
| Authorized Official Contact | 5412666778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coos Health And Wellness 281 Laclair Street Coos Bay OR 97420 Ph: (541) 266-6700 | Coos Health And Wellness 281 Laclair Street Coos Bay OR 97420 Ph: (541) 266-6700 |
| NPI Number | 1811981053 |
|---|---|
| Provider Enumeration Date | 09/02/2005 |
| Last Update Date | 01/09/2024 |
| Medicare PECOS PAC ID | 1759353071 |
|---|---|
| Medicare Enrollment ID | O20040818001343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811981053 | NPI | - | NPPES |
| 500500169 | Medicaid | OR | |
| 500602110 | Medicaid | OR |
| Provider Name | Jeanine S Collier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427166487 PECOS PAC ID: 7113990417 Enrollment ID: I20040816000543 |
| Provider Name | Pallav Pareek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922232644 PECOS PAC ID: 9537300215 Enrollment ID: I20130723000064 |
| Provider Name | Kathleen M Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306095955 PECOS PAC ID: 1951460351 Enrollment ID: I20161207000324 |
| Provider Name | Aloycha L De La Roche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568469773 PECOS PAC ID: 2668497017 Enrollment ID: I20190606000879 |
| Provider Name | Avery Karyn Erickson Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316369051 PECOS PAC ID: 8921337270 Enrollment ID: I20190911002191 |
| Provider Name | Mildred L Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942267703 PECOS PAC ID: 1052543071 Enrollment ID: I20210811001722 |
| Provider Name | Alisse Anna Diers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922607936 PECOS PAC ID: 6800200973 Enrollment ID: I20210831001451 |
| Provider Name | Demetria Bales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144613134 PECOS PAC ID: 9638577836 Enrollment ID: I20211001000589 |
| Provider Name | Samantha D Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982950432 PECOS PAC ID: 2264689884 Enrollment ID: I20230308002008 |
| Provider Name | Jellirica Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962904722 PECOS PAC ID: 2860756277 Enrollment ID: I20231006002182 |
| Provider Name | Rachelle T Chevalier |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1548631138 PECOS PAC ID: 1557704855 Enrollment ID: I20240202003014 |
| Provider Name | David W Geels |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720299480 PECOS PAC ID: 6406038116 Enrollment ID: I20240214004291 |
| Provider Name | Douglas D Shupe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346556180 PECOS PAC ID: 4587008743 Enrollment ID: I20240215004310 |
| Provider Name | Greg Garrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295340156 PECOS PAC ID: 5193169019 Enrollment ID: I20240220001008 |
| Provider Name | Jamilah C Mooney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720350606 PECOS PAC ID: 8022454594 Enrollment ID: I20240307001286 |
| Provider Name | Trisha A Jordan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700097250 PECOS PAC ID: 7810333812 Enrollment ID: I20240313001242 |
| Provider Name | Megan A Ridle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841448396 PECOS PAC ID: 1254777261 Enrollment ID: I20240313001707 |
| Provider Name | William G Simon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003193657 PECOS PAC ID: 9931545852 Enrollment ID: I20240313002358 |
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