| Grace Lake, | |
|
930 Sw Abbey St, Newport, OR 97365-4820 | |
| (541) 265-2244 | |
| Not Available |
| Full Name | Grace Lake |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 930 Sw Abbey St, Newport, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124752233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA221993 (Oregon) | Primary |
| Entity Name | Samaritan Pacific Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174888010 PECOS PAC ID: 2466353529 Enrollment ID: O20040204000304 |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Lake, 930 Sw Abbey St, Newport, OR 97365-4820 Ph: Not Available | Grace Lake, 930 Sw Abbey St, Newport, OR 97365-4820 Ph: (541) 265-2244 |
Mr. Christopher Michael Hart, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 930 Sw Abbey St Ste A, Newport, OR 97365 Phone: 541-265-8816 |
Stanley R Ferguson, P.A.-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 775 Sw 9th St, Suite B, Newport, OR 97365 Phone: 541-265-2007 Fax: 541-265-3533 |
Ms. Baotran Trannguyen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 705 Sw Coast Hwy Ste B, Newport, OR 97365 Phone: 541-574-4860 |
Michelle A Pelkey, PHYSICIAN ASSISTANT Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2002 Se Marine Science Dr, Newport, OR 97365 Phone: 541-867-8823 Fax: 541-867-8856 |
Ryan Alan Hawley, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2002 Se Marine Science Dr, Newport, OR 97365 Phone: 541-867-8823 |
Kristina Marie Uehlin, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1010 Sw Coast Hwy Ste 201, Newport, OR 97365 Phone: 541-265-8816 Fax: 541-265-3890 |
Michael P Cruise, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 705 Sw Coast Hwy, Newport, OR 97365 Phone: 541-574-4860 |