| Pacwest Healthcare, Pllc | |
|
9106 W Rutter Pkwy Spokane WA 99208-9210 | |
| (509) 385-4339 | |
| Not Available |
| Full Name | Pacwest Healthcare, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 9106 W Rutter Pkwy, Spokane, Washington |
| Authorized Official Name and Position | Jason Heffernan (PRESIDENT) |
| Authorized Official Contact | 5093854339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacwest Healthcare, Pllc 108 Straight Away Ln Laurel Fork VA 24352-3988 Ph: (276) 730-5919 | Pacwest Healthcare, Pllc 9106 W Rutter Pkwy Spokane WA 99208-9210 Ph: (509) 385-4339 |
| NPI Number | 1952093742 |
|---|---|
| Provider Enumeration Date | 05/22/2023 |
| Last Update Date | 05/22/2023 |
| Medicare PECOS PAC ID | 5395199269 |
|---|---|
| Medicare Enrollment ID | O20230926002769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952093742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jason Heffernan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528107562 PECOS PAC ID: 7113071069 Enrollment ID: I20090812000492 |
| Provider Name | Kristin N Prey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285072264 PECOS PAC ID: 3577704196 Enrollment ID: I20130724000687 |
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