| Mr Gregory Robert Obray, PA-C | |
|
1207 Evergreen Ct, Clarkston, WA 99403-2874 | |
| (509) 769-2254 | |
| (509) 769-2255 |
| Full Name | Mr Gregory Robert Obray |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 13 Years |
| Location | 1207 Evergreen Ct, Clarkston, Washington |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083770192 | NPI | - | NPPES |
| 8204851 | Medicaid | WA | |
| 805208800 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | 00034506 (Washington) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | M7482 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Tri-state Memorial Hospital | Clarkston, WA | Hospital |
| St Joseph Regional Medical Center | Lewiston, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Catalyst Medical Group Pllc | 2365722105 | 31 |
| Tri-state Memorial Hospital | 4082502422 | 33 |
| Catalyst Medical Group Pllc | 2365722105 | 31 |
| Entity Name | Tri-state Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598814352 PECOS PAC ID: 4082502422 Enrollment ID: O20040308001123 |
| Entity Name | Columbia County Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134128911 PECOS PAC ID: 5597653758 Enrollment ID: O20040309000515 |
| Entity Name | Tri-state Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1760485221 PECOS PAC ID: 4082502422 Enrollment ID: O20061104000320 |
| Entity Name | Catalyst Medical Group PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912458787 PECOS PAC ID: 2365722105 Enrollment ID: O20161213001006 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Gregory Robert Obray, PA-C Po Box 189, Clarkston, WA 99403-0189 Ph: (509) 758-2254 | Mr Gregory Robert Obray, PA-C 1207 Evergreen Ct, Clarkston, WA 99403-2874 Ph: (509) 769-2254 |
Mr. Tyler Lee Anderson, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1119 Highland Ave Ste 4, Clarkston, WA 99403 Phone: 509-254-0080 Fax: 509-254-0079 |
Jacob I. Blazzard, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1433 5th St, Clarkston, WA 99403 Phone: 509-758-5141 Fax: 509-758-5299 |
Carolyn Jean Shoemaker, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1433 5th St, Clarkston, WA 99403 Phone: 509-758-5141 Fax: 509-758-5299 |
Victoria Ozeran, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1119 Highland Ave Ste 11, Clarkston, WA 99403 Phone: 509-758-4450 |
Mr. Kyle Marlin Hoffmann, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1221 Highland Ave, Clarkston, WA 99403 Phone: 509-758-5511 |