Express Care Wa Pc | |
1350 Marvin Rd Ne Ste D Lacey WA 98516-3877 | |
(888) 227-3312 | |
Not Available |
Full Name | Express Care Wa Pc |
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Speciality | General Practice |
Location | 1350 Marvin Rd Ne Ste D, Lacey, Washington |
Authorized Official Name and Position | Donald Wayne Anderson (ASSISTANT SECRETARY OF ENROLLMENTS) |
Authorized Official Contact | 4253589786 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Express Care Wa Pc Po Box 5188 Portland OR 97208-5188 Ph: (888) 227-3312 | Express Care Wa Pc 1350 Marvin Rd Ne Ste D Lacey WA 98516-3877 Ph: (888) 227-3312 |
NPI Number | 1821554452 |
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Provider Enumeration Date | 02/19/2019 |
Last Update Date | 05/06/2025 |
Medicare PECOS PAC ID | 6800128067 |
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Medicare Enrollment ID | O20191022000610 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821554452 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Molly Erin Horton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033689641 PECOS PAC ID: 6103164223 Enrollment ID: I20190215001546 |
Provider Name | Kelly Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225283153 PECOS PAC ID: 6709949860 Enrollment ID: I20191213002003 |
Provider Name | Olubanke Babalola |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013329002 PECOS PAC ID: 9133345275 Enrollment ID: I20201119003049 |
Provider Name | Bella Orbino |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710199427 PECOS PAC ID: 4082713946 Enrollment ID: I20201201001329 |
Provider Name | Cynthia Ramsey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003872789 PECOS PAC ID: 5395820864 Enrollment ID: I20210210002435 |
Provider Name | Bonnie E Hinckley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649481896 PECOS PAC ID: 6305913468 Enrollment ID: I20210219001274 |
Provider Name | Jacqueline Sammons |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235539594 PECOS PAC ID: 1052636628 Enrollment ID: I20230915000876 |
Provider Name | Brenna Cain |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528533759 PECOS PAC ID: 6507105996 Enrollment ID: I20240103000750 |
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