| Eleanor Health Professional Wa, Pllc | |
|
4310 Colby Ave Ste 201 Everett WA 98203-2338 | |
| (866) 323-2596 | |
| Not Available |
| Full Name | Eleanor Health Professional Wa, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4310 Colby Ave Ste 201, Everett, Washington |
| Authorized Official Name and Position | Nzinga Ajabu Harrison (OWNER) |
| Authorized Official Contact | 6174190858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eleanor Health Professional Wa, Pllc Po Box 2810 Weaverville NC 28787-2810 Ph: (828) 989-8686 | Eleanor Health Professional Wa, Pllc 4310 Colby Ave Ste 201 Everett WA 98203-2338 Ph: (866) 323-2596 |
| NPI Number | 1043827132 |
|---|---|
| Provider Enumeration Date | 09/23/2020 |
| Last Update Date | 01/14/2021 |
| Certification Date | 01/14/2021 |
| Medicare PECOS PAC ID | 2365855210 |
|---|---|
| Medicare Enrollment ID | O20210113002320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043827132 | NPI | - | NPPES |
| Provider Name | Joseph Walter Dubose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639110281 PECOS PAC ID: 1153342928 Enrollment ID: I20051208000798 |
| Provider Name | Elizabeth J Bartleson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619309440 PECOS PAC ID: 3779850748 Enrollment ID: I20170522002929 |
| Provider Name | Suzanne Renee Kenedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578086559 PECOS PAC ID: 1456624113 Enrollment ID: I20170925001218 |
| Provider Name | Christine D Gray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932344199 PECOS PAC ID: 0547431348 Enrollment ID: I20171130002178 |
| Provider Name | Kenneth Britt Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790270296 PECOS PAC ID: 6901153030 Enrollment ID: I20180720001646 |
| Provider Name | Ellen M Sundstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962688788 PECOS PAC ID: 8022189430 Enrollment ID: I20181115002607 |
| Provider Name | Audrey Cavins-ezell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154899805 PECOS PAC ID: 3971848839 Enrollment ID: I20200303002665 |
| Provider Name | Shicara B Irvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144782095 PECOS PAC ID: 6901131192 Enrollment ID: I20200610001651 |
| Provider Name | Nzinga Ajabu Harrison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518099910 PECOS PAC ID: 5698793875 Enrollment ID: I20210223000886 |
| Provider Name | Stephen William North |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1073611091 PECOS PAC ID: 3476527300 Enrollment ID: I20210507002198 |
| Provider Name | Lindsay Larris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750647038 PECOS PAC ID: 0042430647 Enrollment ID: I20210518000014 |
| Provider Name | Michael S Mcbain |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1265576292 PECOS PAC ID: 8022417179 Enrollment ID: I20210524000676 |
| Provider Name | Marci E Gleicher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447496393 PECOS PAC ID: 2769534445 Enrollment ID: I20210525002793 |
| Provider Name | Jalessa Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013447960 PECOS PAC ID: 3870909419 Enrollment ID: I20210610002523 |
| Provider Name | Susan Poznyansky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205257045 PECOS PAC ID: 8426448663 Enrollment ID: I20211202001888 |
| Provider Name | Claire Whitehead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902056641 PECOS PAC ID: 5092854331 Enrollment ID: I20220127000748 |
| Provider Name | Rewa A Banks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134595416 PECOS PAC ID: 2264729953 Enrollment ID: I20220519001227 |
| Provider Name | Paula Vanessa De La Cruz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114088697 PECOS PAC ID: 3678541315 Enrollment ID: I20220801003279 |
| Provider Name | Holly Bard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265054076 PECOS PAC ID: 4688086218 Enrollment ID: I20220907003115 |
| Provider Name | Richelle Van Buren-walls |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871898437 PECOS PAC ID: 6507127784 Enrollment ID: I20221018002241 |
| Provider Name | Amber Snelson Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437637048 PECOS PAC ID: 8628426756 Enrollment ID: I20231129002019 |
| Provider Name | Misty Leigh Hinkle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164190799 PECOS PAC ID: 0345621991 Enrollment ID: I20231201002686 |
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