| Enabled Health Pllc | |
|
110 W Crawford St Deer Park WA 99006-5356 | |
| (425) 400-9335 | |
| Not Available |
| Full Name | Enabled Health Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 110 W Crawford St, Deer Park, Washington |
| Authorized Official Name and Position | Bethany Doran (CEO) |
| Authorized Official Contact | 4254009335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enabled Health Pllc 11216 20th St Se Lake Stevens WA 98258-4748 Ph: () - | Enabled Health Pllc 110 W Crawford St Deer Park WA 99006-5356 Ph: (425) 400-9335 |
| NPI Number | 1831858240 |
|---|---|
| Provider Enumeration Date | 12/13/2021 |
| Last Update Date | 07/17/2023 |
| Medicare PECOS PAC ID | 9830577469 |
|---|---|
| Medicare Enrollment ID | O20220609001753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831858240 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Primary |
| Provider Name | Bethany Doran |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619261641 PECOS PAC ID: 6709006026 Enrollment ID: I20200807002615 |
| Provider Name | Charles Okamura |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427254192 PECOS PAC ID: 8426147067 Enrollment ID: I20221118001961 |
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