| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 02/19/2019 |
| Last Update Date | 05/06/2025 |
| Certification Date | 05/06/2025 |
| Medicare PECOS PAC ID | 6800128067 |
|---|---|
| Medicare Enrollment ID | O20191022000610 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821554452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| 261Q00000X | Clinic/center | () | Secondary |
| Provider Name | Oivind Westereng |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295044394 PECOS PAC ID: 4587836234 Enrollment ID: I20111001000001 |
| Provider Name | Kelly Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225283153 PECOS PAC ID: 6709949860 Enrollment ID: I20191213002003 |
| Provider Name | Olubanke Babalola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013329002 PECOS PAC ID: 9133345275 Enrollment ID: I20201119003049 |
| Provider Name | Bella Orbino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710199427 PECOS PAC ID: 4082713946 Enrollment ID: I20201201001329 |
| Provider Name | Bonnie E Hinckley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649481896 PECOS PAC ID: 6305913468 Enrollment ID: I20210219001274 |
| Provider Name | Elizabeth France |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578508321 PECOS PAC ID: 4486739521 Enrollment ID: I20210707003556 |
| Provider Name | Hayley Meyer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336682236 PECOS PAC ID: 4284014234 Enrollment ID: I20220707002965 |
| Provider Name | Jacqueline Sammons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235539594 PECOS PAC ID: 1052636628 Enrollment ID: I20230915000876 |
| Provider Name | Brenna Cain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528533759 PECOS PAC ID: 6507105996 Enrollment ID: I20240103000750 |
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