| Hni Medical Services Of Washington, Pc | |
|
1242 11th St Clarkston WA 99403-2815 | |
| (440) 542-5000 | |
| Not Available |
| Full Name | Hni Medical Services Of Washington, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1242 11th St, Clarkston, Washington |
| Authorized Official Name and Position | Ryan Carletti (VICE PRESIDENT OF OPERATIONS) |
| Authorized Official Contact | 4405425000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hni Medical Services Of Washington, Pc 30575 Bainbridge Rd Solon OH 44139-2221 Ph: (440) 542-5000 | Hni Medical Services Of Washington, Pc 1242 11th St Clarkston WA 99403-2815 Ph: (440) 542-5000 |
| NPI Number | 1922679349 |
|---|---|
| Provider Enumeration Date | 07/07/2021 |
| Last Update Date | 08/22/2023 |
| Medicare PECOS PAC ID | 5799180089 |
|---|---|
| Medicare Enrollment ID | O20210825001275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922679349 | NPI | - | NPPES |
| Provider Name | John Bradley Rudolph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548503022 PECOS PAC ID: 1759604309 Enrollment ID: I20150106001908 |
| Provider Name | Jessica R Six |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588117410 PECOS PAC ID: 3678856861 Enrollment ID: I20200409003602 |
| Provider Name | Seth Six |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164039988 PECOS PAC ID: 3678985645 Enrollment ID: I20201216000171 |
| Provider Name | Brandon L Whitlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124353719 PECOS PAC ID: 9436572740 Enrollment ID: I20211214002643 |
| Provider Name | Connie Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881228781 PECOS PAC ID: 8123430709 Enrollment ID: I20220617001448 |
| Provider Name | Esther Spataro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619611415 PECOS PAC ID: 4688045735 Enrollment ID: I20230127000852 |
| Provider Name | Mark E Houghton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760182984 PECOS PAC ID: 1658734371 Enrollment ID: I20230829002084 |
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