| Lifeline Connections | |
|
1601 E Fourth Plain Blvd Building 17 Vancouver WA 98661-3753 | |
| (360) 397-8246 | |
| Not Available |
| Full Name | Lifeline Connections |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 1601 E Fourth Plain Blvd, Vancouver, Washington |
| Authorized Official Name and Position | Kinh Reynolds (CFO) |
| Authorized Official Contact | 3603978246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeline Connections Po Box 1678 Vancouver WA 98668-1678 Ph: (360) 397-8246 | Lifeline Connections 1601 E Fourth Plain Blvd Building 17 Vancouver WA 98661-3753 Ph: (360) 397-8246 |
| NPI Number | 1689892473 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 03/01/2023 |
| Certification Date | 03/01/2023 |
| Medicare PECOS PAC ID | 2860758307 |
|---|---|
| Medicare Enrollment ID | O20171115003724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689892473 | NPI | - | NPPES |
| 1990126 | Medicaid | WA |
| Provider Name | Catherine L Owen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720155435 PECOS PAC ID: 0648237420 Enrollment ID: I20041213001084 |
| Provider Name | Melanie J Throckmorton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669434031 PECOS PAC ID: 2961424601 Enrollment ID: I20051222000286 |
| Provider Name | Andrea Harrell Chiavarini |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255536405 PECOS PAC ID: 2264526540 Enrollment ID: I20101007001001 |
| Provider Name | Nancy Pascua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780702399 PECOS PAC ID: 0143469627 Enrollment ID: I20130612000650 |
| Provider Name | Elizabeth P Liu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821408386 PECOS PAC ID: 9335417856 Enrollment ID: I20170623002006 |
| Provider Name | Anita T Sassaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952644965 PECOS PAC ID: 1355589474 Enrollment ID: I20180104001722 |
| Provider Name | Marika D Wolfe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992966311 PECOS PAC ID: 7517139223 Enrollment ID: I20180115000448 |
| Provider Name | Angela D Franke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366700825 PECOS PAC ID: 1658535539 Enrollment ID: I20200115001575 |
| Provider Name | Kara V Seibert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356897904 PECOS PAC ID: 7618333477 Enrollment ID: I20230519002878 |
| Provider Name | Cynthia Awadzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164994000 PECOS PAC ID: 2264836709 Enrollment ID: I20231027000934 |
| Provider Name | Arlene A. Chandra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679094668 PECOS PAC ID: 4789032681 Enrollment ID: I20231204001600 |
| Provider Name | Linda Pierre-paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710575410 PECOS PAC ID: 2769878560 Enrollment ID: I20240105001209 |
| Provider Name | Daniel D Jass |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1285067397 PECOS PAC ID: 8123462371 Enrollment ID: I20240215003915 |
| Provider Name | Sylvie G Djoumessi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477321644 PECOS PAC ID: 2062951858 Enrollment ID: I20240823003561 |
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