| Chewelah Associated Physicians Ps | |
|
410 E King St Chewelah WA 99109-0137 | |
| (509) 935-8711 | |
| (509) 935-4882 |
| Full Name | Chewelah Associated Physicians Ps |
|---|---|
| Speciality | Family Medicine |
| Location | 410 E King St, Chewelah, Washington |
| Authorized Official Name and Position | Thomas John Boone (CEO) |
| Authorized Official Contact | 5099358711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chewelah Associated Physicians Ps Po Box 137 Chewelah WA 99109-0137 Ph: (509) 935-8711 | Chewelah Associated Physicians Ps 410 E King St Chewelah WA 99109-0137 Ph: (509) 935-8711 |
| NPI Number | 1104971365 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 06/25/2009 |
| Medicare PECOS PAC ID | 9537057765 |
|---|---|
| Medicare Enrollment ID | O20040309000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104971365 | NPI | - | NPPES |
| 8901404 | Other | WA | DEPT OF L&I |
| 7123300 | Medicaid | WA | |
| 7590946 | Medicaid | WA | |
| 7109173 | Medicaid | WA | |
| CN7261 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ellen L Imsland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821021478 PECOS PAC ID: 8325051501 Enrollment ID: I20060712000030 |
| Provider Name | Thomas J Boone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346325750 PECOS PAC ID: 1355438318 Enrollment ID: I20071107000684 |
| Provider Name | James G Sisco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447310347 PECOS PAC ID: 6709976392 Enrollment ID: I20071219000748 |
| Provider Name | Kimberlyn A Johnstone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528128907 PECOS PAC ID: 7618051327 Enrollment ID: I20080219000697 |
Chewelah Associated Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 E King St, Chewelah, WA 99109 Phone: 509-935-8711 Fax: 509-935-4882 | |
Chewelah Community Health Center Pharmacy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 518 E Clay Ave, Chewelah, WA 99109 Phone: 509-935-8424 Fax: 509-935-8402 | |
Chewelah Family Chiropractic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 301 E Clay Ave Ste 219, Chewelah, WA 99109 Phone: 509-936-6822 Fax: 509-936-4885 | |
Chewelah Associated Physicians Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 E King St, Chewelah, WA 99109 Phone: 509-935-8711 Fax: 509-935-4882 | |
Providence Physician Services Co Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 E Webster Ave, Chewelah, WA 99109 Phone: 509-935-8211 | |
Chewelah Family Chiropractic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 301 E Clay Ave, Suite 219, Chewelah, WA 99109 Phone: 509-935-6822 Fax: 509-935-4885 |