| Maple Medical | |
|
3919 N Maple St Spokane WA 99205-1349 | |
| (509) 444-8888 | |
| (509) 444-8706 |
| Full Name | Maple Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 3919 N Maple St, Spokane, Washington |
| Authorized Official Name and Position | Aaron Wilson (CEO) |
| Authorized Official Contact | 5094448888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maple Medical 731 N Iron Bridge Way Spokane WA 99202-4926 Ph: (509) 444-8888 | Maple Medical 3919 N Maple St Spokane WA 99205-1349 Ph: (509) 444-8888 |
| NPI Number | 1326005851 |
|---|---|
| Provider Enumeration Date | 04/27/2006 |
| Last Update Date | 01/05/2026 |
| Certification Date | 01/05/2026 |
| Medicare PECOS PAC ID | 9638063217 |
|---|---|
| Medicare Enrollment ID | O20040212000971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326005851 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
| Provider Name | Lisa Kunz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851349807 PECOS PAC ID: 0749172690 Enrollment ID: I20040326000293 |
| Provider Name | Kemunto Phoebe Kakumba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528096435 PECOS PAC ID: 5294729703 Enrollment ID: I20040408000986 |
| Provider Name | Letitia Lee Mccully |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780613547 PECOS PAC ID: 1850386814 Enrollment ID: I20040419000930 |
| Provider Name | William M Bomberger |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639194079 PECOS PAC ID: 5597753954 Enrollment ID: I20040504000940 |
| Provider Name | Barry E Linehan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508848276 PECOS PAC ID: 7113915109 Enrollment ID: I20040506000610 |
| Provider Name | Camtu M Thai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518950682 PECOS PAC ID: 2264419514 Enrollment ID: I20040702001251 |
| Provider Name | Timothy E Crum |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306848775 PECOS PAC ID: 7618955352 Enrollment ID: I20040709000911 |
| Provider Name | Samir S Keblawi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790777472 PECOS PAC ID: 9739167933 Enrollment ID: I20040713001083 |
| Provider Name | Monica Blykowski-may |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114929932 PECOS PAC ID: 9436138880 Enrollment ID: I20040719000560 |
| Provider Name | Robert B Lutz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245267897 PECOS PAC ID: 9335110311 Enrollment ID: I20040803001454 |
| Provider Name | Jeremy D Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093767303 PECOS PAC ID: 4688645575 Enrollment ID: I20040804000525 |
| Provider Name | John E Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598847576 PECOS PAC ID: 1052383130 Enrollment ID: I20040810000100 |
| Provider Name | Ethan M Angell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265490247 PECOS PAC ID: 3678540911 Enrollment ID: I20040915000565 |
| Provider Name | Thomas J Byrne |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164581849 PECOS PAC ID: 2365402112 Enrollment ID: I20041015000208 |
| Provider Name | Aaron P Scott |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770571887 PECOS PAC ID: 6204825854 Enrollment ID: I20050113000988 |
| Provider Name | Lisa G Gainer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578605366 PECOS PAC ID: 3375580228 Enrollment ID: I20050412000797 |
| Provider Name | Robby C Riddle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942293055 PECOS PAC ID: 9931141256 Enrollment ID: I20050526000666 |
| Provider Name | Jennifer R Burger |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205042520 PECOS PAC ID: 0749299170 Enrollment ID: I20060413000165 |
| Provider Name | Kimberly a Grandinetti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801888524 PECOS PAC ID: 0941206460 Enrollment ID: I20061005000628 |
| Provider Name | Petru Groza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730187360 PECOS PAC ID: 3577530385 Enrollment ID: I20061017000455 |
| Provider Name | Margaret J Dancan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609894369 PECOS PAC ID: 6103814470 Enrollment ID: I20061023000324 |
| Provider Name | Denise R Barnes |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1003908468 PECOS PAC ID: 6901886555 Enrollment ID: I20061212000410 |
| Provider Name | Kristen L Winther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821140591 PECOS PAC ID: 9234231606 Enrollment ID: I20070305000065 |
| Provider Name | Vicki Bolton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811928187 PECOS PAC ID: 8022115930 Enrollment ID: I20070529000317 |
| Provider Name | Wendy K Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346346509 PECOS PAC ID: 8325148166 Enrollment ID: I20070710000394 |
| Provider Name | Ginger R Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245345909 PECOS PAC ID: 1153422787 Enrollment ID: I20070725000686 |
| Provider Name | Tanya Keeble |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619000569 PECOS PAC ID: 1153422605 Enrollment ID: I20070727000215 |
| Provider Name | Kevin W Cardwell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1588852503 PECOS PAC ID: 8022106475 Enrollment ID: I20071119000161 |
| Provider Name | Samuel E Schneider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700831823 PECOS PAC ID: 3678582707 Enrollment ID: I20080131000018 |
| Provider Name | Kathryn E Sander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215118732 PECOS PAC ID: 7113001355 Enrollment ID: I20080226000636 |
| Provider Name | Fleur L Coulter |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1194754044 PECOS PAC ID: 2062508724 Enrollment ID: I20080325000047 |
| Provider Name | William Lockwood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508952201 PECOS PAC ID: 5193803567 Enrollment ID: I20080425000099 |
| Provider Name | Roberta Knorr |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720047624 PECOS PAC ID: 4880687367 Enrollment ID: I20080515000187 |
| Provider Name | Alexandra S Carey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467661116 PECOS PAC ID: 9335215607 Enrollment ID: I20080910000508 |
| Provider Name | Daniel J Troupe |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023211729 PECOS PAC ID: 5193893329 Enrollment ID: I20081001000337 |
| Provider Name | Kristofer K Johnson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548411770 PECOS PAC ID: 4385702869 Enrollment ID: I20081028000399 |
| Provider Name | Barbara a Brandon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114192218 PECOS PAC ID: 8527120930 Enrollment ID: I20081218000654 |
| Provider Name | Robyn L Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437302247 PECOS PAC ID: 6709948953 Enrollment ID: I20081222000416 |
| Provider Name | Deborah J Wiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467627430 PECOS PAC ID: 2961564075 Enrollment ID: I20081226000194 |
| Provider Name | Bernadine Bank |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1215175641 PECOS PAC ID: 0648336222 Enrollment ID: I20090305000627 |
| Provider Name | Brett E Enlow |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528113768 PECOS PAC ID: 4082770573 Enrollment ID: I20090309000269 |
| Provider Name | Ana S Rosa-ruiz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922245687 PECOS PAC ID: 2860540093 Enrollment ID: I20090428000273 |
| Provider Name | Daniel R Moorman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619932696 PECOS PAC ID: 9537212626 Enrollment ID: I20090807000180 |
| Provider Name | Kingsley Ccameroon Ugorji |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932122116 PECOS PAC ID: 8123172889 Enrollment ID: I20090813000803 |
| Provider Name | James J Larsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558399162 PECOS PAC ID: 5092852996 Enrollment ID: I20091026000680 |
| Provider Name | Mark a Triplett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508192519 PECOS PAC ID: 3779623061 Enrollment ID: I20091217000319 |
| Provider Name | Martha J Nelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326090630 PECOS PAC ID: 5395886337 Enrollment ID: I20100112000868 |
| Provider Name | David R Greeley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386758712 PECOS PAC ID: 2365434081 Enrollment ID: I20100208000649 |
| Provider Name | Shelley L Northern |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1457500852 PECOS PAC ID: 8628105053 Enrollment ID: I20100416000229 |
| Provider Name | Tamara L Bruns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578886305 PECOS PAC ID: 5496884934 Enrollment ID: I20100521000557 |
| Provider Name | John R Colver |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063738052 PECOS PAC ID: 9335278225 Enrollment ID: I20100602000912 |
| Provider Name | Brian K Lasalle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689992836 PECOS PAC ID: 1052442233 Enrollment ID: I20100702000234 |
| Provider Name | Jesse Alan Schneider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598728412 PECOS PAC ID: 2668506403 Enrollment ID: I20100817000062 |
| Provider Name | Rogelio Cantu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942238886 PECOS PAC ID: 6406970920 Enrollment ID: I20100903000659 |
| Provider Name | Lauri K Moon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689987604 PECOS PAC ID: 5698961365 Enrollment ID: I20101119000593 |
| Provider Name | Nedal Gara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205076916 PECOS PAC ID: 3072709401 Enrollment ID: I20101124001094 |
| Provider Name | William Osebold |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922018340 PECOS PAC ID: 7113116351 Enrollment ID: I20110104000840 |
| Provider Name | Elizabeth a Tomeo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154541480 PECOS PAC ID: 4789873217 Enrollment ID: I20110113000812 |
| Provider Name | Lila a Erickson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003134867 PECOS PAC ID: 0042499188 Enrollment ID: I20110121000556 |
| Provider Name | Janet Deegan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033141080 PECOS PAC ID: 9537340666 Enrollment ID: I20110223000457 |
| Provider Name | Colleen E Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245535632 PECOS PAC ID: 0648453803 Enrollment ID: I20110324000818 |
| Provider Name | Kristen M Maefsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528363835 PECOS PAC ID: 7911181524 Enrollment ID: I20110406000210 |
| Provider Name | Cari R Rodgers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437457546 PECOS PAC ID: 9234313560 Enrollment ID: I20110412000446 |
| Provider Name | Tyler C Pedersen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003034828 PECOS PAC ID: 4486727468 Enrollment ID: I20110512000758 |
| Provider Name | Erika a Valtinson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770760118 PECOS PAC ID: 4688732498 Enrollment ID: I20110610000420 |
| Provider Name | Anna Irwin Pietro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649571191 PECOS PAC ID: 9436327947 Enrollment ID: I20110727000146 |
| Provider Name | Wilfred Alex Madarang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003079294 PECOS PAC ID: 7810167905 Enrollment ID: I20110829000177 |
| Provider Name | Kristin Edgehouse |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922200286 PECOS PAC ID: 8921139783 Enrollment ID: I20111020000778 |
| Provider Name | Anne Marie Mccarthy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194864181 PECOS PAC ID: 3779742457 Enrollment ID: I20120315000723 |
| Provider Name | Keri Smith |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1720350440 PECOS PAC ID: 3375703119 Enrollment ID: I20120402000165 |
| Provider Name | Kevin Donahoe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801073457 PECOS PAC ID: 4385827666 Enrollment ID: I20120430000110 |
| Provider Name | Alicia F Powell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437317989 PECOS PAC ID: 3577727908 Enrollment ID: I20120614000222 |
| Provider Name | Lisa a Freeland |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1013952571 PECOS PAC ID: 9436193059 Enrollment ID: I20120620000605 |
| Provider Name | Aimee M Gence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255695300 PECOS PAC ID: 7416105903 Enrollment ID: I20120906000620 |
| Provider Name | Alena F Ponkratov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164785531 PECOS PAC ID: 9133370828 Enrollment ID: I20121105000703 |
| Provider Name | Tobias M Lopez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760736177 PECOS PAC ID: 8921250556 Enrollment ID: I20121206000220 |
| Provider Name | Kathryn S Garrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730423096 PECOS PAC ID: 4385898709 Enrollment ID: I20130211000503 |
| Provider Name | Jennifer M Hopper |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598014565 PECOS PAC ID: 1658525035 Enrollment ID: I20130212000470 |
| Provider Name | Todd M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801869664 PECOS PAC ID: 7618050063 Enrollment ID: I20130613000508 |
| Provider Name | Odessa Marie Ramos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518273960 PECOS PAC ID: 0244472033 Enrollment ID: I20130807000281 |
| Provider Name | Jordan V Espiritu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982910329 PECOS PAC ID: 4183866841 Enrollment ID: I20130808000269 |
| Provider Name | Laura Baehner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003990516 PECOS PAC ID: 3274776125 Enrollment ID: I20130826000585 |
| Provider Name | Donna L Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972939114 PECOS PAC ID: 5092941336 Enrollment ID: I20131115000675 |
| Provider Name | Katie Marie Kasunick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285063644 PECOS PAC ID: 9133356918 Enrollment ID: I20131227000113 |
| Provider Name | David L Holden |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083056303 PECOS PAC ID: 1658500590 Enrollment ID: I20140218001829 |
| Provider Name | Charlotte N Pecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447671680 PECOS PAC ID: 3274766290 Enrollment ID: I20140428002054 |
| Provider Name | Jenna R Kanter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063737302 PECOS PAC ID: 1850514456 Enrollment ID: I20140529001641 |
| Provider Name | Ashley R Wilson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1356575807 PECOS PAC ID: 9537210661 Enrollment ID: I20140717000740 |
| Provider Name | Nancy L Nichols |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760420095 PECOS PAC ID: 2567551898 Enrollment ID: I20140805001095 |
| Provider Name | Ashlee D Mickelson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104027861 PECOS PAC ID: 3870712300 Enrollment ID: I20140916001694 |
| Provider Name | Seth Kasunick |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598065492 PECOS PAC ID: 2860714920 Enrollment ID: I20141201001858 |
| Provider Name | Katrina H Schneider |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548663693 PECOS PAC ID: 2466775663 Enrollment ID: I20141218002579 |
| Provider Name | Jessica L Grogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780074096 PECOS PAC ID: 7214254671 Enrollment ID: I20150323002332 |
| Provider Name | Stanley O Saylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588707582 PECOS PAC ID: 8123047651 Enrollment ID: I20150325000259 |
| Provider Name | Alexander N Luger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558684191 PECOS PAC ID: 7618132267 Enrollment ID: I20150519000672 |
| Provider Name | Shelby R Rush |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144290586 PECOS PAC ID: 5698665198 Enrollment ID: I20150601000423 |
| Provider Name | Bridget a Steiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780810663 PECOS PAC ID: 1850443813 Enrollment ID: I20150731015357 |
| Provider Name | Gary L Noland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093747719 PECOS PAC ID: 1254515463 Enrollment ID: I20150804005706 |
| Provider Name | Joseph B Accursio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528400652 PECOS PAC ID: 4587894340 Enrollment ID: I20150827001281 |
| Provider Name | Brian a Tennant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023499308 PECOS PAC ID: 3971810318 Enrollment ID: I20150916002671 |
| Provider Name | John Henry Kabosky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427328731 PECOS PAC ID: 8820246200 Enrollment ID: I20151001003056 |
| Provider Name | Douglas Hammerstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316998354 PECOS PAC ID: 8628028586 Enrollment ID: I20151005000295 |
| Provider Name | Kirstin Johnson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1386020287 PECOS PAC ID: 1052620549 Enrollment ID: I20151023001249 |
| Provider Name | David O Hornby |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659773935 PECOS PAC ID: 5092024513 Enrollment ID: I20151023002557 |
| Provider Name | Jill White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073837472 PECOS PAC ID: 6608008867 Enrollment ID: I20151104000302 |
| Provider Name | Jeffrey M Hayward |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003218389 PECOS PAC ID: 0244540110 Enrollment ID: I20151104001951 |
| Provider Name | Angela K Hoener |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619348786 PECOS PAC ID: 4981905361 Enrollment ID: I20151209002412 |
| Provider Name | Kerry Traugott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396118469 PECOS PAC ID: 3779885884 Enrollment ID: I20160106002341 |
| Provider Name | Brianna M Mcgerty |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417387820 PECOS PAC ID: 3173753647 Enrollment ID: I20160419002826 |
| Provider Name | Kelly Kleiderer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1033494315 PECOS PAC ID: 4183850175 Enrollment ID: I20160429000944 |
| Provider Name | Elizabeth Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790985083 PECOS PAC ID: 6608955489 Enrollment ID: I20160621001775 |
| Provider Name | Lindsey Anagnostopoulos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477921617 PECOS PAC ID: 0446544266 Enrollment ID: I20160802001591 |
| Provider Name | Paula Dygert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609853993 PECOS PAC ID: 4486621919 Enrollment ID: I20160921001517 |
| Provider Name | Elizabeth Brooks Loft |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558707760 PECOS PAC ID: 7911228093 Enrollment ID: I20161003001383 |
| Provider Name | Veronica Jessick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205279890 PECOS PAC ID: 0547558132 Enrollment ID: I20161014000435 |
| Provider Name | Christina a Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396293445 PECOS PAC ID: 4981982295 Enrollment ID: I20161020001054 |
| Provider Name | Erin E Saunders |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740347293 PECOS PAC ID: 2365660891 Enrollment ID: I20161025000792 |
| Provider Name | Katherine Longinotti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033561766 PECOS PAC ID: 1759660772 Enrollment ID: I20161115002681 |
| Provider Name | Connie Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669793188 PECOS PAC ID: 5294015640 Enrollment ID: I20161201000920 |
| Provider Name | Robert Rodgers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407249840 PECOS PAC ID: 7719267053 Enrollment ID: I20161202002191 |
| Provider Name | Tamara Ganahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114476439 PECOS PAC ID: 4183904238 Enrollment ID: I20161206002136 |
| Provider Name | Caitlin Miller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245773571 PECOS PAC ID: 2769762681 Enrollment ID: I20161212002351 |
| Provider Name | Kristina Weiss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578010310 PECOS PAC ID: 7012297930 Enrollment ID: I20161212002409 |
| Provider Name | Bridget Lonergan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699228536 PECOS PAC ID: 8921389594 Enrollment ID: I20161220001440 |
| Provider Name | William T Cobb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841499498 PECOS PAC ID: 5991087579 Enrollment ID: I20170113001493 |
| Provider Name | Mark R Ingoldby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568907244 PECOS PAC ID: 5698057644 Enrollment ID: I20170126002008 |
| Provider Name | Luis R Manriquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174969729 PECOS PAC ID: 2769623297 Enrollment ID: I20170602002333 |
| Provider Name | Joshua Landsverk |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285167684 PECOS PAC ID: 5890067391 Enrollment ID: I20170817003526 |
| Provider Name | Kyle Rattray |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730568114 PECOS PAC ID: 8527332451 Enrollment ID: I20170915002467 |
| Provider Name | Lauren Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508228388 PECOS PAC ID: 1759656937 Enrollment ID: I20171014000478 |
| Provider Name | Ashlie M Seals |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245533587 PECOS PAC ID: 2264744010 Enrollment ID: I20171023001546 |
| Provider Name | Nathan Mccloskey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164944609 PECOS PAC ID: 2264798537 Enrollment ID: I20171102002986 |
| Provider Name | Garret Leigh Mcquesten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609246743 PECOS PAC ID: 7214293059 Enrollment ID: I20171109003192 |
| Provider Name | Chad Imler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760906853 PECOS PAC ID: 6901162783 Enrollment ID: I20171110001220 |
| Provider Name | Meghan Dwyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174053599 PECOS PAC ID: 3678830494 Enrollment ID: I20171204002728 |
| Provider Name | Vikram Singh Gill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720494768 PECOS PAC ID: 1254557101 Enrollment ID: I20171222001135 |
| Provider Name | Megan Eby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629350822 PECOS PAC ID: 5193084440 Enrollment ID: I20180115000269 |
| Provider Name | Kayla L Navarro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083007363 PECOS PAC ID: 2062771215 Enrollment ID: I20180115000506 |
| Provider Name | Michael Perez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497209571 PECOS PAC ID: 1658630843 Enrollment ID: I20180116000930 |
| Provider Name | Deborah Slizewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669442380 PECOS PAC ID: 4688691199 Enrollment ID: I20180219000694 |
| Provider Name | Annette Anderson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1457869976 PECOS PAC ID: 1254692510 Enrollment ID: I20180228003005 |
| Provider Name | Taylor Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124535042 PECOS PAC ID: 9638430929 Enrollment ID: I20180301000968 |
| Provider Name | Julie a Mccormick |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1467808873 PECOS PAC ID: 1254692544 Enrollment ID: I20180301001097 |
| Provider Name | Jennifer Loweree |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1518475961 PECOS PAC ID: 1052672201 Enrollment ID: I20180302001482 |
| Provider Name | Andrea Rowan May |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679993737 PECOS PAC ID: 7012273089 Enrollment ID: I20180323001498 |
| Provider Name | Kristen Senter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356799498 PECOS PAC ID: 8325300312 Enrollment ID: I20180403002392 |
| Provider Name | Alison J Fenske |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1821504903 PECOS PAC ID: 8426311937 Enrollment ID: I20180416002394 |
| Provider Name | Benjamin Schmelzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164922217 PECOS PAC ID: 2264796481 Enrollment ID: I20180515002526 |
| Provider Name | Brandie Tilch-bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053810309 PECOS PAC ID: 4981969938 Enrollment ID: I20180523001060 |
| Provider Name | Cindy Rose Brigham-althoff |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649773060 PECOS PAC ID: 9032474937 Enrollment ID: I20180524000707 |
| Provider Name | Lisa J Frizzell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952805913 PECOS PAC ID: 3779848387 Enrollment ID: I20180601001043 |
| Provider Name | Joshua Kistner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942620307 PECOS PAC ID: 5597011577 Enrollment ID: I20180705001030 |
| Provider Name | Elise a Rose |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1598255275 PECOS PAC ID: 6901155183 Enrollment ID: I20180821003035 |
| Provider Name | Joleen M Brisbois |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619102902 PECOS PAC ID: 7012261613 Enrollment ID: I20181119000699 |
| Provider Name | Sonia a Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427535566 PECOS PAC ID: 4183978794 Enrollment ID: I20181119001337 |
| Provider Name | Janelle ; Henderson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518443696 PECOS PAC ID: 2466797857 Enrollment ID: I20181212002400 |
| Provider Name | Amanda R Oropeza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740625029 PECOS PAC ID: 1456658491 Enrollment ID: I20181220002072 |
| Provider Name | Ebony Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336629518 PECOS PAC ID: 1052656857 Enrollment ID: I20181226001020 |
| Provider Name | Genevieve Lorwren Baxter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114495058 PECOS PAC ID: 6103162599 Enrollment ID: I20190104002939 |
| Provider Name | Daniel J Boyd |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386162998 PECOS PAC ID: 1951647700 Enrollment ID: I20190115002804 |
| Provider Name | Theo Ray Orchard |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649607102 PECOS PAC ID: 3476779315 Enrollment ID: I20190328001794 |
| Provider Name | Lance M Melin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336667542 PECOS PAC ID: 1153662648 Enrollment ID: I20190410001748 |
| Provider Name | Jesus P Rendon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467970616 PECOS PAC ID: 1951634526 Enrollment ID: I20190613001555 |
| Provider Name | Soraya O Aragundi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326104324 PECOS PAC ID: 5294801684 Enrollment ID: I20190625000437 |
| Provider Name | Michelle C.G. Signs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821381336 PECOS PAC ID: 3577706423 Enrollment ID: I20190726001721 |
| Provider Name | Deepa Krishnamurthi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538487004 PECOS PAC ID: 0749237642 Enrollment ID: I20190814003443 |
| Provider Name | Adrianne M Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083279491 PECOS PAC ID: 2264769074 Enrollment ID: I20190815002555 |
| Provider Name | Jeremy R Deerheim |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710454541 PECOS PAC ID: 6002144755 Enrollment ID: I20190820001871 |
| Provider Name | Mark E Whitney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578576534 PECOS PAC ID: 3173709946 Enrollment ID: I20190917003217 |
| Provider Name | Gregory Ian Collin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962064683 PECOS PAC ID: 4981934767 Enrollment ID: I20190920000536 |
| Provider Name | Rhena Valentine |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1003478207 PECOS PAC ID: 2961734199 Enrollment ID: I20191021003082 |
| Provider Name | Chad W Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437710001 PECOS PAC ID: 5092047001 Enrollment ID: I20191024000589 |
| Provider Name | Holly J Hollis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265770234 PECOS PAC ID: 1658703483 Enrollment ID: I20191118001013 |
| Provider Name | Michael S Colver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003386525 PECOS PAC ID: 0244663680 Enrollment ID: I20191126000319 |
| Provider Name | Rhiannon a Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366090110 PECOS PAC ID: 8921431206 Enrollment ID: I20191126002584 |
| Provider Name | Lisa M Soehren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760860647 PECOS PAC ID: 4789987892 Enrollment ID: I20200103001767 |
| Provider Name | Marissa Anne Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609437508 PECOS PAC ID: 1658706023 Enrollment ID: I20200113000587 |
| Provider Name | Joy a Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689804973 PECOS PAC ID: 4183760101 Enrollment ID: I20200129001016 |
| Provider Name | Kendra E Lemery |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164062527 PECOS PAC ID: 2365878873 Enrollment ID: I20200131002543 |
| Provider Name | Cecilia G Zebedeo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356743744 PECOS PAC ID: 4082978317 Enrollment ID: I20200217000284 |
| Provider Name | Marcy R Pacheco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366095754 PECOS PAC ID: 3476980616 Enrollment ID: I20200227001327 |
| Provider Name | Anya Krmpotich Corcoran |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750911293 PECOS PAC ID: 9436586229 Enrollment ID: I20200228000915 |
| Provider Name | Tamara Marene Brower |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1194210674 PECOS PAC ID: 5890049639 Enrollment ID: I20200406002882 |
| Provider Name | Clint M Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427405034 PECOS PAC ID: 3779875968 Enrollment ID: I20200409001390 |
| Provider Name | Yvette GD Rosser |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720472996 PECOS PAC ID: 9739421637 Enrollment ID: I20200409003453 |
| Provider Name | Ryan M Lysne |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528526993 PECOS PAC ID: 1355771106 Enrollment ID: I20200420002038 |
| Provider Name | Dashiel Wham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760023469 PECOS PAC ID: 5294162517 Enrollment ID: I20200512003093 |
| Provider Name | Katherine H Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336784628 PECOS PAC ID: 5395166466 Enrollment ID: I20200527001678 |
| Provider Name | Toni M Keel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841835782 PECOS PAC ID: 7719308535 Enrollment ID: I20200603002880 |
| Provider Name | Amy J Hagins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003381492 PECOS PAC ID: 9537582044 Enrollment ID: I20200630002762 |
| Provider Name | Miguel a Posada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992320949 PECOS PAC ID: 2668897372 Enrollment ID: I20200728004032 |
| Provider Name | Lich Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316478183 PECOS PAC ID: 1557786332 Enrollment ID: I20200805000918 |
| Provider Name | Laurie L Scheid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326444340 PECOS PAC ID: 4082937008 Enrollment ID: I20200929000792 |
| Provider Name | Liam J Lunstrum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093067357 PECOS PAC ID: 9931324084 Enrollment ID: I20201103002940 |
| Provider Name | Lindsay L Brookhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285231589 PECOS PAC ID: 9133539794 Enrollment ID: I20201110002332 |
| Provider Name | Alisha C Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255809893 PECOS PAC ID: 3274946421 Enrollment ID: I20210106002781 |
| Provider Name | Brendan Tennefoss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528571130 PECOS PAC ID: 4880951391 Enrollment ID: I20210112000863 |
| Provider Name | Julie M Christiansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881020246 PECOS PAC ID: 2961647326 Enrollment ID: I20210128002009 |
| Provider Name | Bogdan D Chaban |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548819683 PECOS PAC ID: 1355756651 Enrollment ID: I20210218002807 |
| Provider Name | Stacy L Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033794565 PECOS PAC ID: 0244634947 Enrollment ID: I20210803000867 |
| Provider Name | Stephanie Michelle Biggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447867098 PECOS PAC ID: 9335551597 Enrollment ID: I20210812001385 |
| Provider Name | Grace T Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164991188 PECOS PAC ID: 1658776455 Enrollment ID: I20210817002130 |
| Provider Name | Mirna S Fakhouri |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174192710 PECOS PAC ID: 3375948185 Enrollment ID: I20210817002223 |
| Provider Name | Nicole a Mowbray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043983448 PECOS PAC ID: 5092110098 Enrollment ID: I20210827002857 |
| Provider Name | Katharine V Dickinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215467071 PECOS PAC ID: 6204232200 Enrollment ID: I20210830003430 |
| Provider Name | Jean Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982275913 PECOS PAC ID: 2668878364 Enrollment ID: I20210903001410 |
| Provider Name | Michael J Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801162656 PECOS PAC ID: 2668785239 Enrollment ID: I20210910002885 |
| Provider Name | Heather M Connor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447928940 PECOS PAC ID: 6901203801 Enrollment ID: I20210920002323 |
| Provider Name | Jill W Lee |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1578239653 PECOS PAC ID: 5597162404 Enrollment ID: I20210920003002 |
| Provider Name | Nelson P Mckay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558855452 PECOS PAC ID: 3678824711 Enrollment ID: I20210929003522 |
| Provider Name | Nicole E Simpson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972107431 PECOS PAC ID: 5496153660 Enrollment ID: I20211004000298 |
| Provider Name | Jamie L White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891467189 PECOS PAC ID: 6608908769 Enrollment ID: I20211019002801 |
| Provider Name | Erik H Leaf |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922774850 PECOS PAC ID: 3173911179 Enrollment ID: I20211025001342 |
| Provider Name | Heidi J Batt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740735224 PECOS PAC ID: 5294123881 Enrollment ID: I20211101002804 |
| Provider Name | Marlena R Benson-kelsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164188587 PECOS PAC ID: 6507256732 Enrollment ID: I20211202001586 |
| Provider Name | Matthew Dubnicka |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619588589 PECOS PAC ID: 5698165637 Enrollment ID: I20211206000957 |
| Provider Name | Danne J Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740899632 PECOS PAC ID: 7810381225 Enrollment ID: I20220301001965 |
| Provider Name | Rebecca B Hauserman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366056335 PECOS PAC ID: 9335533363 Enrollment ID: I20220308001248 |
| Provider Name | Leigh a Trivino |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679631733 PECOS PAC ID: 2961504808 Enrollment ID: I20220613002957 |
| Provider Name | Abel Saba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053083329 PECOS PAC ID: 4486033883 Enrollment ID: I20220615000820 |
| Provider Name | Jordan Ruger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205333762 PECOS PAC ID: 4284017799 Enrollment ID: I20220816003359 |
| Provider Name | Nicholas Paul Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518690023 PECOS PAC ID: 8325421324 Enrollment ID: I20220823002831 |
| Provider Name | Austin Brekke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083346050 PECOS PAC ID: 9739562778 Enrollment ID: I20220824000157 |
| Provider Name | Nicole Falkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679215081 PECOS PAC ID: 9537543095 Enrollment ID: I20220831003942 |
| Provider Name | Vanessa Y Shaughnessey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427786417 PECOS PAC ID: 8426433467 Enrollment ID: I20220912003574 |
| Provider Name | William G Fernandez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073589255 PECOS PAC ID: 5597722199 Enrollment ID: I20220913003739 |
| Provider Name | Marlee J Swem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194457382 PECOS PAC ID: 7911382502 Enrollment ID: I20220919000488 |
| Provider Name | Mara M Hazeltine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689134181 PECOS PAC ID: 0648656967 Enrollment ID: I20221010001863 |
| Provider Name | Zoey Mckenna Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235796251 PECOS PAC ID: 5890171110 Enrollment ID: I20221010002048 |
| Provider Name | Kristin a Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740746247 PECOS PAC ID: 3971910704 Enrollment ID: I20221027003164 |
| Provider Name | Spencer a Hale |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952079295 PECOS PAC ID: 1052788031 Enrollment ID: I20221103002111 |
| Provider Name | Ardeth R Mcauley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1477280865 PECOS PAC ID: 4688041668 Enrollment ID: I20221103002180 |
| Provider Name | Nathan Joel Moreno Sim |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932877115 PECOS PAC ID: 2567830102 Enrollment ID: I20221201002062 |
| Provider Name | Ahmed G Abdelshafy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457029795 PECOS PAC ID: 8527436187 Enrollment ID: I20221201003087 |
| Provider Name | Luke Mark Walton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487277836 PECOS PAC ID: 2961829676 Enrollment ID: I20221206002568 |
| Provider Name | Kristi M Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689390825 PECOS PAC ID: 9335518729 Enrollment ID: I20221206003247 |
| Provider Name | Chelsea Kuckovic |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174146245 PECOS PAC ID: 6608245949 Enrollment ID: I20221208002521 |
| Provider Name | Jacob D Helm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871204636 PECOS PAC ID: 5395116875 Enrollment ID: I20230119002525 |
| Provider Name | Anna E Denton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003331539 PECOS PAC ID: 7315213790 Enrollment ID: I20230130002454 |
| Provider Name | Carly L Villarreal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396206884 PECOS PAC ID: 1951773191 Enrollment ID: I20230215003174 |
| Provider Name | Anastasia G Tunstall Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497342943 PECOS PAC ID: 4688082332 Enrollment ID: I20230228000886 |
| Provider Name | Jessica R Rutland |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033816798 PECOS PAC ID: 4385018282 Enrollment ID: I20230315002879 |
| Provider Name | Kenneth H Power |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831457373 PECOS PAC ID: 7416179437 Enrollment ID: I20230501001341 |
| Provider Name | Andrew E Gardner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902268238 PECOS PAC ID: 7012256605 Enrollment ID: I20230501002472 |
| Provider Name | Vera Nyonglemuga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073102737 PECOS PAC ID: 5597161323 Enrollment ID: I20230512002299 |
| Provider Name | Hannah N Mckee-kennedy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164866083 PECOS PAC ID: 0941503320 Enrollment ID: I20230615002641 |
| Provider Name | Julia a Platt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003500612 PECOS PAC ID: 2466812755 Enrollment ID: I20230718003410 |
| Provider Name | Haley M Wilkes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073074696 PECOS PAC ID: 4082031281 Enrollment ID: I20230724000048 |
| Provider Name | Jade L Graff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780376061 PECOS PAC ID: 7810357803 Enrollment ID: I20230724000100 |
| Provider Name | Jana R Pedersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699319483 PECOS PAC ID: 5799114666 Enrollment ID: I20230725004263 |
| Provider Name | Julia a Fast |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659840247 PECOS PAC ID: 4183085442 Enrollment ID: I20230802002905 |
| Provider Name | Nicole E Bruey-pernell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386253714 PECOS PAC ID: 7416317318 Enrollment ID: I20230808003997 |
| Provider Name | Rose V Maros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154001972 PECOS PAC ID: 3779945381 Enrollment ID: I20230814004015 |
| Provider Name | Samantha K Knapp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023799541 PECOS PAC ID: 8921461039 Enrollment ID: I20230822003824 |
| Provider Name | Elisabeth H Cope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568046779 PECOS PAC ID: 9133583438 Enrollment ID: I20230919002465 |
| Provider Name | Carroll N Altsholer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275251183 PECOS PAC ID: 3476907361 Enrollment ID: I20230926003331 |
| Provider Name | Elizabeth M Quiroz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912249384 PECOS PAC ID: 2365669009 Enrollment ID: I20231002002981 |
| Provider Name | Andy M Zhang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902433329 PECOS PAC ID: 0941627772 Enrollment ID: I20231003000687 |
| Provider Name | Lisabeth C Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043473796 PECOS PAC ID: 0345410130 Enrollment ID: I20231005000188 |
| Provider Name | Rana Helen Pullom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295217495 PECOS PAC ID: 5890142236 Enrollment ID: I20231107002882 |
| Provider Name | Michelle D Timmerman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497306674 PECOS PAC ID: 5799134128 Enrollment ID: I20231211003502 |
| Provider Name | Margaret a Carfield |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144696154 PECOS PAC ID: 8224487657 Enrollment ID: I20231211003555 |
| Provider Name | Elicia a Spotts |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164402947 PECOS PAC ID: 4789033093 Enrollment ID: I20231212003085 |
| Provider Name | Troy E Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700356086 PECOS PAC ID: 7517316623 Enrollment ID: I20231214003149 |
| Provider Name | Alexis M Prothe |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1801395074 PECOS PAC ID: 5597114504 Enrollment ID: I20231214003687 |
| Provider Name | Alycia N Crowley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679029607 PECOS PAC ID: 3274983143 Enrollment ID: I20231219002854 |
| Provider Name | Robert J Townley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063838266 PECOS PAC ID: 6608226741 Enrollment ID: I20240102001517 |
| Provider Name | Sierra Dean |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1942831524 PECOS PAC ID: 2668822727 Enrollment ID: I20240102002065 |
| Provider Name | Jamie L Rosteck |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568006922 PECOS PAC ID: 7517318595 Enrollment ID: I20240104001454 |
| Provider Name | Megan N Bidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841887940 PECOS PAC ID: 4486005881 Enrollment ID: I20240110002723 |
| Provider Name | Jaime M Sparber |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467088930 PECOS PAC ID: 4183073117 Enrollment ID: I20240122000776 |
| Provider Name | Theresa M Allen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265598007 PECOS PAC ID: 8820441561 Enrollment ID: I20240129003558 |
| Provider Name | Grant a Guiley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366825283 PECOS PAC ID: 1052764701 Enrollment ID: I20240129003821 |
| Provider Name | Joshua D Ott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700211943 PECOS PAC ID: 1759734403 Enrollment ID: I20240129003934 |
| Provider Name | Shannon M Schoonover |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801039714 PECOS PAC ID: 0345683124 Enrollment ID: I20240208002269 |
| Provider Name | Hilda J Caquias Chamorro |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316258916 PECOS PAC ID: 3678916194 Enrollment ID: I20240212001811 |
| Provider Name | Katianne W Kelsey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184964058 PECOS PAC ID: 0648614941 Enrollment ID: I20240214002763 |
| Provider Name | Joshua a Bruns |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063047751 PECOS PAC ID: 5092159764 Enrollment ID: I20240221001951 |
| Provider Name | Mirenna G Scott |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1770354151 PECOS PAC ID: 1355785056 Enrollment ID: I20240221003124 |
| Provider Name | Kristy E Brooten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750145769 PECOS PAC ID: 7012356512 Enrollment ID: I20240417000564 |
| Provider Name | Susan K Baker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558053140 PECOS PAC ID: 6709225733 Enrollment ID: I20240423002959 |
| Provider Name | Lauren E Morris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073158580 PECOS PAC ID: 5698114627 Enrollment ID: I20240423003041 |
| Provider Name | Mattilynn C Naccarato |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912476565 PECOS PAC ID: 9739528787 Enrollment ID: I20240423003806 |
| Provider Name | Matthew D Dach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669513214 PECOS PAC ID: 1850733254 Enrollment ID: I20240530004034 |
| Provider Name | Emily J Kellogg |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1568219251 PECOS PAC ID: 4385187210 Enrollment ID: I20240620002371 |
| Provider Name | Amy V Shoop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548937378 PECOS PAC ID: 5597208371 Enrollment ID: I20240621000406 |
| Provider Name | Jennifer a Spink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881442424 PECOS PAC ID: 3577007004 Enrollment ID: I20240626000201 |
| Provider Name | Lisa Louise Taylor-tussey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306311568 PECOS PAC ID: 4688118771 Enrollment ID: I20240701000660 |
| Provider Name | Tabetha S Ratliff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609458850 PECOS PAC ID: 2466854153 Enrollment ID: I20240702002674 |
| Provider Name | Elliott James Van Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356922579 PECOS PAC ID: 4688075260 Enrollment ID: I20240712003947 |
| Provider Name | Brent L Conrad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518544337 PECOS PAC ID: 4486003506 Enrollment ID: I20240722003478 |
| Provider Name | Amelie M Tristant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063260313 PECOS PAC ID: 3476091117 Enrollment ID: I20240813003331 |
| Provider Name | Elizabeth N Jacobs |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518610112 PECOS PAC ID: 9133667199 Enrollment ID: I20240821002851 |
| Provider Name | Katherine Joy Whipple |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275519712 PECOS PAC ID: 1658388731 Enrollment ID: I20240822000056 |
| Provider Name | Emily L Christie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598511255 PECOS PAC ID: 0840739843 Enrollment ID: I20240822000094 |
| Provider Name | Jay L Olivares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104550607 PECOS PAC ID: 7113466624 Enrollment ID: I20240828003618 |
| Provider Name | Katie a Roberts |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386327294 PECOS PAC ID: 4082153424 Enrollment ID: I20240828005066 |
| Provider Name | Courtney L Polimeni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174254916 PECOS PAC ID: 3072053792 Enrollment ID: I20240909004476 |
| Provider Name | Shannon C Valentine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457109746 PECOS PAC ID: 5799225413 Enrollment ID: I20240909004543 |
| Provider Name | Christy E Barsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811493042 PECOS PAC ID: 2961766639 Enrollment ID: I20240919003628 |
| Provider Name | Kye S Dixson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619328556 PECOS PAC ID: 1557640471 Enrollment ID: I20240923002714 |
| Provider Name | Daniel I Zebedeo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255959003 PECOS PAC ID: 0143696757 Enrollment ID: I20241024003459 |
| Provider Name | William B Liening |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710610027 PECOS PAC ID: 0345773248 Enrollment ID: I20241031000023 |
| Provider Name | Malia M Vance |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053145623 PECOS PAC ID: 2163955063 Enrollment ID: I20241031000035 |
| Provider Name | Abigail J Hurtubise |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962220749 PECOS PAC ID: 9335672070 Enrollment ID: I20241101002125 |
| Provider Name | Megan E Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174350003 PECOS PAC ID: 5294269940 Enrollment ID: I20241118000940 |
| Provider Name | Neil H Liotta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285217489 PECOS PAC ID: 8527460567 Enrollment ID: I20241120004479 |
| Provider Name | Cody J Ashby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235518044 PECOS PAC ID: 0143755058 Enrollment ID: I20241129000329 |
| Provider Name | Elissa M Black |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659896892 PECOS PAC ID: 9335674167 Enrollment ID: I20241203000876 |
| Provider Name | Alexis R Paul |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1174380356 PECOS PAC ID: 5991230757 Enrollment ID: I20241203001980 |
| Provider Name | Tammy Le |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932922218 PECOS PAC ID: 0042746844 Enrollment ID: I20241203003943 |
| Provider Name | Kiersten M Black |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891482154 PECOS PAC ID: 4385170190 Enrollment ID: I20241203004696 |
| Provider Name | Arlene E Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245578020 PECOS PAC ID: 6103275128 Enrollment ID: I20241209002382 |
| Provider Name | Allison G Slamkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922856178 PECOS PAC ID: 8325571896 Enrollment ID: I20241209002934 |
| Provider Name | Yvonne S Zgraggen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326711292 PECOS PAC ID: 6406382621 Enrollment ID: I20241211003907 |
| Provider Name | Andrea D Griechen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053857094 PECOS PAC ID: 8628506367 Enrollment ID: I20250109001207 |
| Provider Name | Autumn J Shkuratoff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346708633 PECOS PAC ID: 0648629733 Enrollment ID: I20250304003931 |
| Provider Name | Tiffanie C Hoffmeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679387864 PECOS PAC ID: 0042734238 Enrollment ID: I20250409002020 |
| Provider Name | Erica J Tuell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396306890 PECOS PAC ID: 0446774640 Enrollment ID: I20250409002324 |
| Provider Name | Anne Howard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912653932 PECOS PAC ID: 4688061716 Enrollment ID: I20250502001862 |
| Provider Name | Bornell Nicholson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1295186294 PECOS PAC ID: 0547772451 Enrollment ID: I20250625003497 |
| Provider Name | Brittany R Aguila |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952790784 PECOS PAC ID: 1557710571 Enrollment ID: I20250721000229 |
| Provider Name | Olivia R Courser |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1700507530 PECOS PAC ID: 5294241964 Enrollment ID: I20250721000478 |
| Provider Name | Meredith R Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457028466 PECOS PAC ID: 7618485905 Enrollment ID: I20250806003563 |
| Provider Name | Robert J Rech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659166296 PECOS PAC ID: 7719485051 Enrollment ID: I20250807000720 |
| Provider Name | Mary E Ricco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588475487 PECOS PAC ID: 5799284709 Enrollment ID: I20250818000951 |
| Provider Name | Julia R Robins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801682273 PECOS PAC ID: 4486154895 Enrollment ID: I20250821000049 |
| Provider Name | Cecil Peter Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972113421 PECOS PAC ID: 3971987421 Enrollment ID: I20250904003062 |
| Provider Name | David L Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073320628 PECOS PAC ID: 2769987379 Enrollment ID: I20250924004502 |
| Provider Name | Veronica R Mundell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043859515 PECOS PAC ID: 5496181067 Enrollment ID: I20251028002539 |
| Provider Name | Sera a Jacob |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821739798 PECOS PAC ID: 9234579194 Enrollment ID: I20260128000355 |
| Provider Name | Hannah L Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811486780 PECOS PAC ID: 6002350501 Enrollment ID: I20260311000092 |
| Provider Name | Abigail S Mitch |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437528486 PECOS PAC ID: 7517276348 Enrollment ID: I20260408002272 |
| Provider Name | Stephanie Posorske |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1457990723 PECOS PAC ID: 1254766140 Enrollment ID: I20260603001204 |
Circ Medical, PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 N Howard St, Suite R, Spokane, WA 99201 Phone: 206-672-1697 |
Market Street Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5921 N Market St, Spokane, WA 99208 Phone: 509-444-8200 Fax: 509-444-7806 |
Kaiser Foundation Health Plan of Washington Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 546 N Jefferson Ln Ste 200, Spokane, WA 99201 Phone: 509-625-3700 |
Basma Care LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 522 W Riverside Ave # 6552, Spokane, WA 99201 Phone: 522-576-8918 |
Swiggum Internal Medicine, PLLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2903 E 25th Ave, Spokane, WA 99223 Phone: 509-536-6700 Fax: 509-536-6856 |
Emergency Responders Health Center, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Rock Pointe Iii; Suite 1080, 1330 N. Washington Street, Spokane, WA 99201 Phone: 208-229-3742 Fax: 208-229-8450 |