| Dhhs Ihs Colville Service Unit | |
|
19 Lakes St Nespelem WA 99155-0071 | |
| (509) 634-2900 | |
| (509) 634-2990 |
| Full Name | Dhhs Ihs Colville Service Unit |
|---|---|
| Speciality | Clinic/Center |
| Location | 19 Lakes St, Nespelem, Washington |
| Authorized Official Name and Position | Yvonne Misiaszek (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5096342900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dhhs Ihs Colville Service Unit 19 Lakes St Nespelem WA 99155-0071 Ph: (509) 634-2900 | Dhhs Ihs Colville Service Unit 19 Lakes St Nespelem WA 99155-0071 Ph: (509) 634-2900 |
| NPI Number | 1811091911 |
|---|---|
| Provider Enumeration Date | 09/11/2006 |
| Last Update Date | 05/19/2008 |
| Medicare PECOS PAC ID | 0941302509 |
|---|---|
| Medicare Enrollment ID | O20070228000304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811091911 | NPI | - | NPPES |
| 7100100 | Medicaid | WA | |
| 5400189 | Medicaid | WA | |
| 7139660 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Sandra Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083653836 PECOS PAC ID: 0648226860 Enrollment ID: I20050330000564 |
| Provider Name | Kathy A Winzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639191091 PECOS PAC ID: 0840398640 Enrollment ID: I20070601000210 |
| Provider Name | Joseph P Santiago |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285667188 PECOS PAC ID: 1153466214 Enrollment ID: I20100301000959 |
| Provider Name | Shayne P Blevins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538305057 PECOS PAC ID: 6507907540 Enrollment ID: I20101028001373 |
| Provider Name | Peggy W Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275898405 PECOS PAC ID: 1355582545 Enrollment ID: I20130731000363 |
| Provider Name | Loren L Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275603037 PECOS PAC ID: 0143313817 Enrollment ID: I20150318002091 |
| Provider Name | Sheila M Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194814822 PECOS PAC ID: 6608975735 Enrollment ID: I20150518000364 |
| Provider Name | Gregory Barcus |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1902983562 PECOS PAC ID: 9830221837 Enrollment ID: I20150527001958 |
| Provider Name | Jacqueline M Sellner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003213430 PECOS PAC ID: 6507183654 Enrollment ID: I20150624001249 |
| Provider Name | Qiyu Huang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619250131 PECOS PAC ID: 4587838867 Enrollment ID: I20160404000555 |
| Provider Name | Melinda K Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164415006 PECOS PAC ID: 4082701487 Enrollment ID: I20160617000258 |
| Provider Name | Debra S Scheel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568468189 PECOS PAC ID: 5496778391 Enrollment ID: I20161202000087 |
| Provider Name | Larry Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639131386 PECOS PAC ID: 8729061189 Enrollment ID: I20170724003308 |
| Provider Name | Michael L Turnington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356890206 PECOS PAC ID: 9830468818 Enrollment ID: I20170822000259 |
| Provider Name | Connie I Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538139027 PECOS PAC ID: 1355233313 Enrollment ID: I20171116002520 |
| Provider Name | Phillip Luther Shealy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811394935 PECOS PAC ID: 3577873264 Enrollment ID: I20171128003355 |
| Provider Name | Shauna Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962952028 PECOS PAC ID: 9830456532 Enrollment ID: I20171206000003 |
| Provider Name | Emily Poloji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922491349 PECOS PAC ID: 8729351564 Enrollment ID: I20180103000645 |
| Provider Name | Theresa Caniff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407210172 PECOS PAC ID: 4385905090 Enrollment ID: I20180220002488 |
| Provider Name | Robert L Holman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225083587 PECOS PAC ID: 7517919095 Enrollment ID: I20180308002306 |
| Provider Name | Nuanphan S Poole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801393707 PECOS PAC ID: 4385993591 Enrollment ID: I20180822000261 |
| Provider Name | Victoria E Brookshire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275679961 PECOS PAC ID: 3274762901 Enrollment ID: I20181010000731 |
| Provider Name | Alison M Pingitore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538518113 PECOS PAC ID: 5294028668 Enrollment ID: I20181105000381 |
| Provider Name | Francoise Bansenga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275877409 PECOS PAC ID: 8022303213 Enrollment ID: I20190417000399 |
| Provider Name | Micheal Scott Feuerborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740842053 PECOS PAC ID: 9133551179 Enrollment ID: I20191113002594 |
| Provider Name | Deanna A Pritchett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841779634 PECOS PAC ID: 9537591219 Enrollment ID: I20191119000266 |
| Provider Name | Kenya Kawanee Hemingway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093083420 PECOS PAC ID: 2062679152 Enrollment ID: I20200128000899 |
| Provider Name | Andrew J Trego |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053439331 PECOS PAC ID: 6103255443 Enrollment ID: I20200715003310 |
| Provider Name | Michael Blue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558309393 PECOS PAC ID: 5991793135 Enrollment ID: I20210115002377 |
| Provider Name | Johnna Diane Tunnyhill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245901701 PECOS PAC ID: 0547650467 Enrollment ID: I20211209000038 |
| Provider Name | Randall Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013029735 PECOS PAC ID: 5597867465 Enrollment ID: I20211217001285 |
Dssh Ihs Colville Service Unit Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 Lakes Street, Nespelem, WA 99155 Phone: 509-634-2900 Fax: 509-634-2990 | |
Colville Indian Health Service Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 Lakes Street, Nespelem, WA 99155 Phone: 509-634-2913 Fax: 509-634-2945 |