| Peacehealth | |
|
1615 Delaware St Longview WA 98632-2367 | |
| (360) 414-2000 | |
| (360) 414-2054 |
| Full Name | Peacehealth |
|---|---|
| Speciality | Clinic/Center |
| Location | 1615 Delaware St, Longview, Washington |
| Authorized Official Name and Position | Thomas Haywood (REGIONAL VP/CFO) |
| Authorized Official Contact | 3604145797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peacehealth Po Box 3002 Longview WA 98632-0302 Ph: (360) 414-2000 | Peacehealth 1615 Delaware St Longview WA 98632-2367 Ph: (360) 414-2000 |
| NPI Number | 1720056187 |
|---|---|
| Provider Enumeration Date | 03/10/2006 |
| Last Update Date | 07/29/2011 |
| Medicare PECOS PAC ID | 5890689293 |
|---|---|
| Medicare Enrollment ID | O20040209000272 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720056187 | NPI | - | NPPES |
| Provider Name | Laila A Naqib-osman |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1821039777 PECOS PAC ID: 5698689222 Enrollment ID: I20031118000035 |
| Provider Name | Lisa M Harrison |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760439079 PECOS PAC ID: 1850299686 Enrollment ID: I20031230000606 |
| Provider Name | Carol A Hooff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992734255 PECOS PAC ID: 4587659529 Enrollment ID: I20040419000527 |
| Provider Name | Suzanne Gerhart |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699773390 PECOS PAC ID: 5092701995 Enrollment ID: I20040426000014 |
| Provider Name | Ramona K Sherman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033105036 PECOS PAC ID: 8527042498 Enrollment ID: I20040617000295 |
| Provider Name | James M Harle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124014121 PECOS PAC ID: 6002888062 Enrollment ID: I20040810000803 |
| Provider Name | Joseph Goyzman |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1598850455 PECOS PAC ID: 5395719124 Enrollment ID: I20040825001499 |
| Provider Name | Ritawari Sharangpani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154473015 PECOS PAC ID: 8921069600 Enrollment ID: I20041026000253 |
| Provider Name | Riyad Caradog Karmy-jones |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023077500 PECOS PAC ID: 5597728055 Enrollment ID: I20041105000955 |
| Provider Name | Louis W Cotterell |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1811994668 PECOS PAC ID: 8325079320 Enrollment ID: I20050830000387 |
| Provider Name | Andrea J Young |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437174489 PECOS PAC ID: 1759350556 Enrollment ID: I20051004001162 |
| Provider Name | Lisa M Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891790580 PECOS PAC ID: 4183649148 Enrollment ID: I20051008000147 |
| Provider Name | Adrian Sorin Bucerzan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1306891601 PECOS PAC ID: 4880669746 Enrollment ID: I20051010000515 |
| Provider Name | Robin Virgin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801812334 PECOS PAC ID: 9133144892 Enrollment ID: I20051011001160 |
| Provider Name | Jason J Suh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437150976 PECOS PAC ID: 5799702130 Enrollment ID: I20051026000022 |
| Provider Name | Michael I Mcnellis |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649262171 PECOS PAC ID: 9133139124 Enrollment ID: I20060504000894 |
| Provider Name | Holly J Bassler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437103009 PECOS PAC ID: 3173535630 Enrollment ID: I20060627000066 |
| Provider Name | Patrick M Lassen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1285632919 PECOS PAC ID: 0446147946 Enrollment ID: I20060731000091 |
| Provider Name | Chad C Chesley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1831197243 PECOS PAC ID: 5991718470 Enrollment ID: I20060731000139 |
| Provider Name | Robert C Axelrod |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285628099 PECOS PAC ID: 5496758328 Enrollment ID: I20060816000014 |
| Provider Name | Gretchen M Potschka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811994718 PECOS PAC ID: 3375546211 Enrollment ID: I20060816000122 |
| Provider Name | Clifford J Schostal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215939905 PECOS PAC ID: 3274536073 Enrollment ID: I20060817000069 |
| Provider Name | Michael L Bartlett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356348502 PECOS PAC ID: 7113920927 Enrollment ID: I20060817000160 |
| Provider Name | James T Crider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669479689 PECOS PAC ID: 7911900725 Enrollment ID: I20060817000186 |
| Provider Name | Timothy A Randall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245237262 PECOS PAC ID: 0446253108 Enrollment ID: I20060818000039 |
| Provider Name | Shawn J Aaron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578560710 PECOS PAC ID: 6507869260 Enrollment ID: I20060818000064 |
| Provider Name | Vivian A Lombillo |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1013938620 PECOS PAC ID: 0446254924 Enrollment ID: I20060914000608 |
| Provider Name | Mohiedean Ghofrani |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1588646228 PECOS PAC ID: 0446271894 Enrollment ID: I20061012000614 |
| Provider Name | Kirsten G Buswell |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1679667026 PECOS PAC ID: 4587666417 Enrollment ID: I20070206000587 |
| Provider Name | Jeffrey R Davis |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1871507251 PECOS PAC ID: 6204938426 Enrollment ID: I20070219000437 |
| Provider Name | Adam S Wilson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1790745933 PECOS PAC ID: 9830291079 Enrollment ID: I20070219000660 |
| Provider Name | Christine M Katterhagen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477551646 PECOS PAC ID: 0244268423 Enrollment ID: I20070315000343 |
| Provider Name | Gina L Wald |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881717866 PECOS PAC ID: 4486746484 Enrollment ID: I20070822000944 |
| Provider Name | Amy K Heiser |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558395699 PECOS PAC ID: 6406951318 Enrollment ID: I20070924000100 |
| Provider Name | Majd Abdelkader Isreb |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1669426243 PECOS PAC ID: 0749273290 Enrollment ID: I20071005000167 |
| Provider Name | Aaron C Varney |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063623429 PECOS PAC ID: 7214023118 Enrollment ID: I20071023000238 |
| Provider Name | Helen H Kim |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1811921570 PECOS PAC ID: 1850473786 Enrollment ID: I20080130000519 |
| Provider Name | Choong R Kim |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1023292950 PECOS PAC ID: 6305929951 Enrollment ID: I20080206000143 |
| Provider Name | John Westerfield |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609850197 PECOS PAC ID: 8921073420 Enrollment ID: I20080218000579 |
| Provider Name | Jaswinderpal Sandhu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841463007 PECOS PAC ID: 1254404197 Enrollment ID: I20080724000843 |
| Provider Name | Renee D Sale |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356352520 PECOS PAC ID: 5597739706 Enrollment ID: I20080808000118 |
| Provider Name | Robert H Joseph |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1750324349 PECOS PAC ID: 9638270135 Enrollment ID: I20080826000498 |
| Provider Name | Gabriella Szilvia Skuta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346486297 PECOS PAC ID: 1153484191 Enrollment ID: I20090116000305 |
| Provider Name | Lan N Pham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548264252 PECOS PAC ID: 7618033580 Enrollment ID: I20090227000428 |
| Provider Name | Marlene E Dietrich |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1124088406 PECOS PAC ID: 8426945635 Enrollment ID: I20090723000698 |
| Provider Name | Jenny B Hobbs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598874224 PECOS PAC ID: 9234284373 Enrollment ID: I20090826000228 |
| Provider Name | Rachel Kristin Corey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871725564 PECOS PAC ID: 1951457464 Enrollment ID: I20090925000091 |
| Provider Name | Matthew A Bolsoy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417154428 PECOS PAC ID: 2062594377 Enrollment ID: I20091105000535 |
| Provider Name | George M Brennan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902883002 PECOS PAC ID: 6608872437 Enrollment ID: I20091201000509 |
| Provider Name | Robert D Bigler |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1689777583 PECOS PAC ID: 2062456304 Enrollment ID: I20100106000488 |
| Provider Name | Nichole R Robbins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871820936 PECOS PAC ID: 4981745114 Enrollment ID: I20100108000901 |
| Provider Name | James R Copeland |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144281023 PECOS PAC ID: 9537241096 Enrollment ID: I20100215000435 |
| Provider Name | James A Suero |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316909419 PECOS PAC ID: 9032244074 Enrollment ID: I20100316001012 |
| Provider Name | Suhail G Bahu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851562946 PECOS PAC ID: 0042356164 Enrollment ID: I20100429000744 |
| Provider Name | Ayesha Akhter |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134174469 PECOS PAC ID: 0345378527 Enrollment ID: I20100507000812 |
| Provider Name | Nicholas K Schiller |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306833108 PECOS PAC ID: 3476459389 Enrollment ID: I20100625000200 |
| Provider Name | Jolanta S Olson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346244043 PECOS PAC ID: 6204924962 Enrollment ID: I20100721000177 |
| Provider Name | Lisa L Doherty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871791236 PECOS PAC ID: 6608967112 Enrollment ID: I20100803001235 |
| Provider Name | Anne M Hamburg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235157496 PECOS PAC ID: 9335171651 Enrollment ID: I20100827000464 |
| Provider Name | David M Tretheway |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073606117 PECOS PAC ID: 3274657960 Enrollment ID: I20100901001026 |
| Provider Name | Camilla Allen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1225048762 PECOS PAC ID: 5395869739 Enrollment ID: I20100907001072 |
| Provider Name | Allan L Harrelson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437360740 PECOS PAC ID: 7911022322 Enrollment ID: I20100908000856 |
| Provider Name | Leon B Stratton |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1477657039 PECOS PAC ID: 0547302499 Enrollment ID: I20100913000809 |
| Provider Name | Rhonda R Dojan |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1417261322 PECOS PAC ID: 4688790017 Enrollment ID: I20100923000242 |
| Provider Name | Carrie E. Sylvester |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306998273 PECOS PAC ID: 1355533662 Enrollment ID: I20101005000862 |
| Provider Name | Kirsten E Redborg |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023105764 PECOS PAC ID: 7214005321 Enrollment ID: I20101109000793 |
| Provider Name | Di Lu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1801978549 PECOS PAC ID: 3476749565 Enrollment ID: I20101201000894 |
| Provider Name | Gayle M Tate Casson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114911922 PECOS PAC ID: 2264629773 Enrollment ID: I20101209001093 |
| Provider Name | Mohamad Imad Haque |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326074345 PECOS PAC ID: 3971697111 Enrollment ID: I20110118000989 |
| Provider Name | Mikhail P Nekhamis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750612917 PECOS PAC ID: 9931382413 Enrollment ID: I20110321000759 |
| Provider Name | Marc D Legras |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881675221 PECOS PAC ID: 1355355462 Enrollment ID: I20110511000364 |
| Provider Name | Peter H Chang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003926189 PECOS PAC ID: 2860492378 Enrollment ID: I20110511000391 |
| Provider Name | James P Kyser |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972584753 PECOS PAC ID: 8921997446 Enrollment ID: I20110511000423 |
| Provider Name | Sarice L Bassin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689691370 PECOS PAC ID: 5890777502 Enrollment ID: I20110527000189 |
| Provider Name | Beejay A Feliciano |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1235273632 PECOS PAC ID: 3173792322 Enrollment ID: I20110804000745 |
| Provider Name | Simon T Lai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588858070 PECOS PAC ID: 3072782689 Enrollment ID: I20110816000000 |
| Provider Name | Shaun L Ageno |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1760692529 PECOS PAC ID: 4183776909 Enrollment ID: I20110912000170 |
| Provider Name | Oleg Nefalimovich Zbirun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760635833 PECOS PAC ID: 2961673793 Enrollment ID: I20110927000434 |
| Provider Name | Clarissa J Weiss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225157225 PECOS PAC ID: 7911178611 Enrollment ID: I20110928000559 |
| Provider Name | Donna K Lynds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043549488 PECOS PAC ID: 2567638968 Enrollment ID: I20120106000398 |
| Provider Name | Sheila D Lynam |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1861434441 PECOS PAC ID: 0143414813 Enrollment ID: I20120222001056 |
| Provider Name | Hasan G Osman |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1346282886 PECOS PAC ID: 9638337579 Enrollment ID: I20120222001070 |
| Provider Name | Tanya K Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699049304 PECOS PAC ID: 1355503897 Enrollment ID: I20120430000707 |
| Provider Name | George Robert Dulabon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649264680 PECOS PAC ID: 4789789322 Enrollment ID: I20120727000546 |
| Provider Name | James P Pepka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821136086 PECOS PAC ID: 4688820277 Enrollment ID: I20120815000042 |
| Provider Name | Nathan W Hileman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730313909 PECOS PAC ID: 0244481836 Enrollment ID: I20121107000483 |
| Provider Name | Jerad R Shoemaker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811150873 PECOS PAC ID: 0547411472 Enrollment ID: I20121127000095 |
| Provider Name | Tyson M Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083811566 PECOS PAC ID: 6901967215 Enrollment ID: I20130212000027 |
| Provider Name | Saeyeal K Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124185665 PECOS PAC ID: 8628122298 Enrollment ID: I20130222000488 |
| Provider Name | Mark Jacob Eichler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285832956 PECOS PAC ID: 2668629809 Enrollment ID: I20130511000115 |
| Provider Name | Vance Y Sohn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649329319 PECOS PAC ID: 2062651821 Enrollment ID: I20130627000117 |
| Provider Name | Fang Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407193790 PECOS PAC ID: 0244471910 Enrollment ID: I20130722000480 |
| Provider Name | Khaled R Pharaon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902090061 PECOS PAC ID: 3375798101 Enrollment ID: I20130730000546 |
| Provider Name | Juanita P Doerksen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679546162 PECOS PAC ID: 8820278120 Enrollment ID: I20130808000577 |
| Provider Name | Dustin Colegrove |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467686147 PECOS PAC ID: 8123277712 Enrollment ID: I20130912000620 |
| Provider Name | Rebecca Suzanne Foreman |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1962639831 PECOS PAC ID: 1153561329 Enrollment ID: I20130913000811 |
| Provider Name | Laura E Lefever |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508000563 PECOS PAC ID: 9739314840 Enrollment ID: I20131025001731 |
| Provider Name | Yolanda Ligsay Vea |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588826176 PECOS PAC ID: 9931257391 Enrollment ID: I20140110000182 |
| Provider Name | Jeremiah Crank |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528230323 PECOS PAC ID: 1254518657 Enrollment ID: I20140320000115 |
| Provider Name | Candace A Clark |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1609297431 PECOS PAC ID: 3870726607 Enrollment ID: I20140501002244 |
| Provider Name | Ronald E Beresky |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417991084 PECOS PAC ID: 3779516232 Enrollment ID: I20140514000644 |
| Provider Name | Catherine S. Murr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851556542 PECOS PAC ID: 3476621939 Enrollment ID: I20140528001864 |
| Provider Name | Kari Edgren |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790124550 PECOS PAC ID: 2567604549 Enrollment ID: I20140702001535 |
| Provider Name | Edwin L Marrero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902198096 PECOS PAC ID: 1658598487 Enrollment ID: I20140818002753 |
| Provider Name | Jennifer Yang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558686527 PECOS PAC ID: 0547413601 Enrollment ID: I20140821000306 |
| Provider Name | Kindra S Lynch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801201900 PECOS PAC ID: 8820217920 Enrollment ID: I20140923001611 |
| Provider Name | Matthew D Lail |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386058386 PECOS PAC ID: 6406076355 Enrollment ID: I20140929000365 |
| Provider Name | Michael James Casey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689615262 PECOS PAC ID: 8628164688 Enrollment ID: I20141013002158 |
| Provider Name | Elnathan P Eldredge |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689073348 PECOS PAC ID: 9537483367 Enrollment ID: I20150126001885 |
| Provider Name | Amy M Canada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982923041 PECOS PAC ID: 0143458588 Enrollment ID: I20150707002822 |
| Provider Name | Corey S Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801116488 PECOS PAC ID: 6002133279 Enrollment ID: I20150723008991 |
| Provider Name | Jesse I Broome |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528308558 PECOS PAC ID: 7315186871 Enrollment ID: I20150805008582 |
| Provider Name | Eric Yang |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1770710386 PECOS PAC ID: 7810202546 Enrollment ID: I20150810002812 |
| Provider Name | Mahesh Dangal |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1710171129 PECOS PAC ID: 4789879115 Enrollment ID: I20150818005862 |
| Provider Name | Robert C Cruz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720166879 PECOS PAC ID: 4486779261 Enrollment ID: I20150818006268 |
| Provider Name | Elizabeth M Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861575060 PECOS PAC ID: 9931269669 Enrollment ID: I20150901002587 |
| Provider Name | Christopher Yu Tu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457618654 PECOS PAC ID: 7618293291 Enrollment ID: I20150909000019 |
| Provider Name | Sandeep Vetteth |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1619132495 PECOS PAC ID: 5890964738 Enrollment ID: I20151020002306 |
| Provider Name | David B Liang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619178027 PECOS PAC ID: 6800948456 Enrollment ID: I20151116002361 |
| Provider Name | Victor N Takla |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770591182 PECOS PAC ID: 6608923065 Enrollment ID: I20151119001652 |
| Provider Name | Joanna R Wimer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780058743 PECOS PAC ID: 9537462429 Enrollment ID: I20160127001436 |
| Provider Name | Christine Louise Crank |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386803161 PECOS PAC ID: 7810294436 Enrollment ID: I20160328000539 |
| Provider Name | Andrew Jensen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831442235 PECOS PAC ID: 4880830504 Enrollment ID: I20160519001991 |
| Provider Name | Erika J Zeff |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1255789152 PECOS PAC ID: 3870536113 Enrollment ID: I20160624002140 |
| Provider Name | Gretchen B Schwinn |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1548527369 PECOS PAC ID: 3870885270 Enrollment ID: I20160705001793 |
| Provider Name | Shashima Nakahara |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437474103 PECOS PAC ID: 4880830256 Enrollment ID: I20160722000685 |
| Provider Name | Andrea J King |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639496052 PECOS PAC ID: 5395983787 Enrollment ID: I20160908000855 |
| Provider Name | Suzanne M Frieberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467656439 PECOS PAC ID: 6507931532 Enrollment ID: I20161027000993 |
| Provider Name | Baljinder Brar |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1255572103 PECOS PAC ID: 8628263316 Enrollment ID: I20161101000462 |
| Provider Name | Wanda Juarros Hanlon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720034242 PECOS PAC ID: 6901798388 Enrollment ID: I20161101001384 |
| Provider Name | Mycroft M Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033408448 PECOS PAC ID: 0345529681 Enrollment ID: I20161109002112 |
| Provider Name | Ossama Al Masalmeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851654776 PECOS PAC ID: 0648571182 Enrollment ID: I20161114000718 |
| Provider Name | Kenneth Y Huang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467800425 PECOS PAC ID: 6800175688 Enrollment ID: I20161118000635 |
| Provider Name | Muhammad Riaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053610493 PECOS PAC ID: 8123330669 Enrollment ID: I20161228001049 |
| Provider Name | Adam R Weeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215303771 PECOS PAC ID: 2769759059 Enrollment ID: I20170516001886 |
| Provider Name | Maura J Frith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124429691 PECOS PAC ID: 2961779038 Enrollment ID: I20170519000999 |
| Provider Name | Dar-jen Michael Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497178016 PECOS PAC ID: 6608147202 Enrollment ID: I20170731003177 |
| Provider Name | Venkata P Konda |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679851786 PECOS PAC ID: 6305065996 Enrollment ID: I20170814002740 |
| Provider Name | Nikhaliza B Nikhassan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568723336 PECOS PAC ID: 1759687536 Enrollment ID: I20170830001460 |
| Provider Name | Sahar Taqui |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063798049 PECOS PAC ID: 0749402238 Enrollment ID: I20170915000030 |
| Provider Name | Heather E Ross Blackford |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821338591 PECOS PAC ID: 4486928082 Enrollment ID: I20170920002818 |
| Provider Name | Nicole R Fox |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1487171070 PECOS PAC ID: 7810254463 Enrollment ID: I20171206002583 |
| Provider Name | Laurie A Womack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801300165 PECOS PAC ID: 4981962560 Enrollment ID: I20180103003308 |
| Provider Name | Jocelyn D Glessing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972985505 PECOS PAC ID: 1355600800 Enrollment ID: I20180109002040 |
| Provider Name | Jagannath H Saikumar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1295999498 PECOS PAC ID: 9032343751 Enrollment ID: I20180213002103 |
| Provider Name | Guangquan Zhao |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1710197314 PECOS PAC ID: 8224288451 Enrollment ID: I20180213002607 |
| Provider Name | Peter J Leyzac |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033451968 PECOS PAC ID: 0547407397 Enrollment ID: I20180316000097 |
| Provider Name | Mark Schuchman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467517300 PECOS PAC ID: 2961683487 Enrollment ID: I20180601001127 |
| Provider Name | Nicole L Landry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891178653 PECOS PAC ID: 9234484122 Enrollment ID: I20180618001684 |
| Provider Name | Tyler J Paradis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003159096 PECOS PAC ID: 0345481974 Enrollment ID: I20180706000833 |
| Provider Name | Chen-wen C Heh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467449629 PECOS PAC ID: 6507885670 Enrollment ID: I20180723002191 |
| Provider Name | Priyanka S Obrien |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326306317 PECOS PAC ID: 0840592838 Enrollment ID: I20180725002685 |
| Provider Name | Oliver J Uy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588174833 PECOS PAC ID: 2062764038 Enrollment ID: I20181003000966 |
| Provider Name | Katie C Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184192189 PECOS PAC ID: 3678819331 Enrollment ID: I20190116003959 |
| Provider Name | Matthew Luce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144748815 PECOS PAC ID: 4587900253 Enrollment ID: I20190117000344 |
| Provider Name | Sandra M Demars |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811212749 PECOS PAC ID: 3173820156 Enrollment ID: I20190125002713 |
| Provider Name | Daniel S Mehr |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396891677 PECOS PAC ID: 9739075540 Enrollment ID: I20190228001949 |
| Provider Name | Robert D Shepherd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487001780 PECOS PAC ID: 7911231956 Enrollment ID: I20190626000577 |
| Provider Name | Sophia J Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154785749 PECOS PAC ID: 2163756024 Enrollment ID: I20190626001671 |
| Provider Name | Jennifer J O'donnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568919694 PECOS PAC ID: 9931432457 Enrollment ID: I20190716003159 |
| Provider Name | Shushan Rana |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1487091260 PECOS PAC ID: 4486888294 Enrollment ID: I20190815000776 |
| Provider Name | Tim H Lee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407019177 PECOS PAC ID: 7618112319 Enrollment ID: I20190906001528 |
| Provider Name | Tien Li Hsiao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760836241 PECOS PAC ID: 9739476136 Enrollment ID: I20190916000229 |
| Provider Name | Farhana Malik |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1770733073 PECOS PAC ID: 9638494206 Enrollment ID: I20191106001244 |
| Provider Name | Peter M Bauchert |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194369645 PECOS PAC ID: 5597199380 Enrollment ID: I20200103000583 |
| Provider Name | Marc Bouchard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750677605 PECOS PAC ID: 3870724867 Enrollment ID: I20200108000813 |
| Provider Name | Cory Scott |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073037495 PECOS PAC ID: 3375805260 Enrollment ID: I20200131001676 |
| Provider Name | Alena Prystupa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568858488 PECOS PAC ID: 5799078267 Enrollment ID: I20200211002751 |
| Provider Name | Karla Maggard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811426844 PECOS PAC ID: 1759649759 Enrollment ID: I20200227001670 |
| Provider Name | Lee D Bendickson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336486786 PECOS PAC ID: 6507144250 Enrollment ID: I20200325002175 |
| Provider Name | Margie N L Tucker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477725794 PECOS PAC ID: 2769608397 Enrollment ID: I20200402003773 |
| Provider Name | Rajdeep Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538545892 PECOS PAC ID: 3173825213 Enrollment ID: I20200419000320 |
| Provider Name | Akram Khan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1710993498 PECOS PAC ID: 1850380973 Enrollment ID: I20200419000344 |
| Provider Name | Jason Hong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881074656 PECOS PAC ID: 9032421466 Enrollment ID: I20200619002448 |
| Provider Name | Tabitha Ku |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801201785 PECOS PAC ID: 1355567769 Enrollment ID: I20200623001038 |
| Provider Name | Steven Jeffrey Urbick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821551490 PECOS PAC ID: 1052733573 Enrollment ID: I20200629003212 |
| Provider Name | Gurleen Dhami |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1235422023 PECOS PAC ID: 0648596379 Enrollment ID: I20200716002592 |
| Provider Name | Jacob Maxwell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568787893 PECOS PAC ID: 6901023159 Enrollment ID: I20200717001436 |
| Provider Name | Timothy J Horrocks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770018087 PECOS PAC ID: 2961773254 Enrollment ID: I20200811003194 |
| Provider Name | Sena Kilic |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1477994101 PECOS PAC ID: 6901125384 Enrollment ID: I20200909000779 |
| Provider Name | Hannah N Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760094726 PECOS PAC ID: 4183042781 Enrollment ID: I20200914002809 |
| Provider Name | Erinn M Rieser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508394917 PECOS PAC ID: 9830464684 Enrollment ID: I20200916001813 |
| Provider Name | Jose Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669086641 PECOS PAC ID: 4183043383 Enrollment ID: I20201007000606 |
| Provider Name | Jaesung Kim |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962834796 PECOS PAC ID: 4789959404 Enrollment ID: I20201111001271 |
| Provider Name | Christine A Bruce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669007605 PECOS PAC ID: 3779997515 Enrollment ID: I20210205002147 |
| Provider Name | Hannah M Catlin |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1013450303 PECOS PAC ID: 5395150171 Enrollment ID: I20210209003001 |
| Provider Name | Julie G Kilzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588123442 PECOS PAC ID: 2264774538 Enrollment ID: I20210322000280 |
| Provider Name | Carly N Chambers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891128336 PECOS PAC ID: 3577832567 Enrollment ID: I20210429001805 |
| Provider Name | Brian Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336461813 PECOS PAC ID: 3072644228 Enrollment ID: I20210608001973 |
| Provider Name | Anuj V Sharma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174921845 PECOS PAC ID: 8224375837 Enrollment ID: I20210614002091 |
| Provider Name | Swathi Tella |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1629243381 PECOS PAC ID: 7416190269 Enrollment ID: I20210715000493 |
| Provider Name | Claire E Wolff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548840911 PECOS PAC ID: 9739582370 Enrollment ID: I20210720003487 |
| Provider Name | Jacob B Beckstrand |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730566852 PECOS PAC ID: 1658680178 Enrollment ID: I20210730002566 |
| Provider Name | Jordan J Allensworth |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1912347675 PECOS PAC ID: 9739460700 Enrollment ID: I20210802000651 |
| Provider Name | David Ormond |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669888103 PECOS PAC ID: 2062701980 Enrollment ID: I20210812001093 |
| Provider Name | Mu-hsiang J Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073009023 PECOS PAC ID: 5890047021 Enrollment ID: I20210816003014 |
| Provider Name | Steven R Spence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023685492 PECOS PAC ID: 3678978400 Enrollment ID: I20210817002988 |
| Provider Name | Leah K Margolis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104346428 PECOS PAC ID: 5890191878 Enrollment ID: I20210831002671 |
| Provider Name | Maura Munoz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720407364 PECOS PAC ID: 8729206529 Enrollment ID: I20210903000161 |
| Provider Name | Juniper Vojta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649502683 PECOS PAC ID: 5698172070 Enrollment ID: I20210928001756 |
| Provider Name | Jared T Williamson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881165421 PECOS PAC ID: 3173862984 Enrollment ID: I20210928003640 |
| Provider Name | Melissa Brinkerhoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235716218 PECOS PAC ID: 4284022484 Enrollment ID: I20211020001616 |
| Provider Name | Christopher Daniel Forward |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861756033 PECOS PAC ID: 5496143190 Enrollment ID: I20211029001296 |
| Provider Name | Kathleen A Parks |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184087520 PECOS PAC ID: 4284979436 Enrollment ID: I20211111001617 |
| Provider Name | Loreen Leu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740563675 PECOS PAC ID: 7810160215 Enrollment ID: I20211117002435 |
| Provider Name | Rohit Singh |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1376823179 PECOS PAC ID: 8123318185 Enrollment ID: I20211213000732 |
| Provider Name | Ura Stokke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457020752 PECOS PAC ID: 7012308307 Enrollment ID: I20211221001027 |
| Provider Name | Nicole Layne Baker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619622776 PECOS PAC ID: 5991190175 Enrollment ID: I20220325000903 |
| Provider Name | Nicholas D Crall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316262645 PECOS PAC ID: 3274761333 Enrollment ID: I20220401001773 |
| Provider Name | Dikshya Sharma |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1639581226 PECOS PAC ID: 4688090418 Enrollment ID: I20220406000780 |
| Provider Name | Sabo Uba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508106873 PECOS PAC ID: 4385889849 Enrollment ID: I20220502000561 |
| Provider Name | Thammasak Mingbunjerdsuk |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720439490 PECOS PAC ID: 1153613849 Enrollment ID: I20220506001677 |
| Provider Name | Anawin Sanguankeo |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1043637580 PECOS PAC ID: 8022233170 Enrollment ID: I20220608002663 |
| Provider Name | Sandra Jean Wheaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841220266 PECOS PAC ID: 4385639442 Enrollment ID: I20220711000944 |
| Provider Name | Nicholas Taylor Duletzke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417319922 PECOS PAC ID: 6204192826 Enrollment ID: I20220802002699 |
| Provider Name | Reena Baharani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659631950 PECOS PAC ID: 5395018865 Enrollment ID: I20220803001505 |
| Provider Name | Manjot Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225619620 PECOS PAC ID: 5395129845 Enrollment ID: I20220831003706 |
| Provider Name | Megan M Schill |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528798279 PECOS PAC ID: 7012391329 Enrollment ID: I20220906003255 |
| Provider Name | Christina K Li |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538693924 PECOS PAC ID: 4486038676 Enrollment ID: I20220907003541 |
| Provider Name | Mark Dudash |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124477617 PECOS PAC ID: 2961797444 Enrollment ID: I20220916002297 |
| Provider Name | Nicholas A Willis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609429125 PECOS PAC ID: 5991187486 Enrollment ID: I20220920002953 |
| Provider Name | Alison Metcalf |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1841222445 PECOS PAC ID: 0840276572 Enrollment ID: I20221017002648 |
| Provider Name | Alexander Shar |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1033280920 PECOS PAC ID: 2062546195 Enrollment ID: I20221101003268 |
| Provider Name | Shawgi Silver |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548611684 PECOS PAC ID: 4880091222 Enrollment ID: I20221108000942 |
| Provider Name | Valaree Ruth Lehrman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598493009 PECOS PAC ID: 0547639791 Enrollment ID: I20221209000437 |
| Provider Name | Sophie C Feller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134514540 PECOS PAC ID: 0446580260 Enrollment ID: I20221219000723 |
| Provider Name | Maria Christina Trevino-jungers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467915876 PECOS PAC ID: 7416321435 Enrollment ID: I20230314002848 |
| Provider Name | Tarig Ahmed |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1669705471 PECOS PAC ID: 5294981437 Enrollment ID: I20230406002277 |
| Provider Name | Muhammad F Khaliq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790168409 PECOS PAC ID: 0244546331 Enrollment ID: I20230419000662 |
| Provider Name | Martina Sczesny-aleshnick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467557918 PECOS PAC ID: 2466479621 Enrollment ID: I20230504000672 |
| Provider Name | Janette Leal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992090708 PECOS PAC ID: 4981844305 Enrollment ID: I20230522003067 |
| Provider Name | Haritha Pabbathi |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1215000989 PECOS PAC ID: 4789683210 Enrollment ID: I20230523002356 |
| Provider Name | Maria Shoaib |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235625922 PECOS PAC ID: 9537526504 Enrollment ID: I20230606003257 |
| Provider Name | Kodjovi D Kodjo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780100958 PECOS PAC ID: 7517203177 Enrollment ID: I20230607003296 |
| Provider Name | Donald Pierce |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790197523 PECOS PAC ID: 4880811264 Enrollment ID: I20230712004215 |
| Provider Name | Abhijeet S Joshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245857861 PECOS PAC ID: 1355765629 Enrollment ID: I20230717000978 |
| Provider Name | Virginia Nguyen |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1821470998 PECOS PAC ID: 8921310632 Enrollment ID: I20230724000508 |
| Provider Name | Mark Wantaja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750907143 PECOS PAC ID: 7911325121 Enrollment ID: I20230804002388 |
| Provider Name | Maanas Tripathi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215429097 PECOS PAC ID: 6709281439 Enrollment ID: I20230817001820 |
| Provider Name | Muaiad Kittaneh |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1730350794 PECOS PAC ID: 7012078058 Enrollment ID: I20230823003331 |
| Provider Name | Melinda Mantooth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639708175 PECOS PAC ID: 3476972381 Enrollment ID: I20230918002159 |
| Provider Name | Nataly Vasquez-encalada |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1992083851 PECOS PAC ID: 2163649823 Enrollment ID: I20230919001580 |
| Provider Name | Kristina Trubey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548502768 PECOS PAC ID: 0749414928 Enrollment ID: I20231005001182 |
| Provider Name | Ashley Dalgarno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376222620 PECOS PAC ID: 3870940273 Enrollment ID: I20231107001126 |
| Provider Name | Jessica Danielle Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871372490 PECOS PAC ID: 4183071343 Enrollment ID: I20231108004051 |
| Provider Name | Stacey Keith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982946729 PECOS PAC ID: 5890098198 Enrollment ID: I20231120003305 |
| Provider Name | Mark Gerard Schwei |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639199110 PECOS PAC ID: 6406176395 Enrollment ID: I20231130001009 |
| Provider Name | Karyn Banke |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831724152 PECOS PAC ID: 7911357793 Enrollment ID: I20231219003631 |
| Provider Name | Kathryn Peralta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902390206 PECOS PAC ID: 2365838091 Enrollment ID: I20240103002734 |
| Provider Name | Deborah Kiehlmeier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124553854 PECOS PAC ID: 4789954454 Enrollment ID: I20240110002037 |
| Provider Name | Tera Middlebrook |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740471911 PECOS PAC ID: 8426443714 Enrollment ID: I20240115000709 |
| Provider Name | Adam Scattergood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760629695 PECOS PAC ID: 5799137758 Enrollment ID: I20240116002082 |
| Provider Name | Charles Steiger |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1104811876 PECOS PAC ID: 3577534635 Enrollment ID: I20240210000492 |
| Provider Name | Lindsey K Frischmann |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629364419 PECOS PAC ID: 4789970815 Enrollment ID: I20240220002532 |
| Provider Name | Alexis Leigh Bullard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447947544 PECOS PAC ID: 0244682672 Enrollment ID: I20240326001717 |
| Provider Name | Rodney J Deaton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003934274 PECOS PAC ID: 8921240425 Enrollment ID: I20240416002962 |
| Provider Name | Alan W Bickel |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1689679144 PECOS PAC ID: 5496640427 Enrollment ID: I20240428000149 |
| Provider Name | Inga Giske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912471228 PECOS PAC ID: 1153752621 Enrollment ID: I20240514002587 |
| Provider Name | Simrandeep Kaur Brar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447821343 PECOS PAC ID: 9638511850 Enrollment ID: I20240520002527 |
| Provider Name | Ryan Hargraves |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306983556 PECOS PAC ID: 9234500745 Enrollment ID: I20240529003502 |
| Provider Name | Iwona Edwards |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578319836 PECOS PAC ID: 6709228042 Enrollment ID: I20240531001521 |
| Provider Name | Ahmer Asif |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912569963 PECOS PAC ID: 9436691334 Enrollment ID: I20240606003255 |
| Provider Name | Baljinder Singh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114589025 PECOS PAC ID: 4981146743 Enrollment ID: I20240607001262 |
| Provider Name | Emilee Jo Browne |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1851163018 PECOS PAC ID: 0446792006 Enrollment ID: I20240611001373 |
| Provider Name | Kyle Backer |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1487066841 PECOS PAC ID: 5698192110 Enrollment ID: I20240620000768 |
| Provider Name | Rachel Do Deak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184088726 PECOS PAC ID: 3072913797 Enrollment ID: I20240729002440 |
| Provider Name | Jaykumar Unni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912353277 PECOS PAC ID: 3072940600 Enrollment ID: I20240731002847 |
| Provider Name | Matthew Metzger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396374898 PECOS PAC ID: 2769805944 Enrollment ID: I20240802002422 |
| Provider Name | Sejal Dave |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1124234901 PECOS PAC ID: 8325191927 Enrollment ID: I20240814002070 |
| Provider Name | Timothy Hutton |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1700315215 PECOS PAC ID: 4385916642 Enrollment ID: I20240816003834 |
| Provider Name | Larry Warner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851552806 PECOS PAC ID: 6406981554 Enrollment ID: I20240917000091 |
| Provider Name | Julie Doherty |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1326526880 PECOS PAC ID: 1951842632 Enrollment ID: I20240920003418 |
| Provider Name | Sonya M Packard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952868671 PECOS PAC ID: 4981135118 Enrollment ID: I20240930000820 |
| Provider Name | Stacey Chong |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1578024519 PECOS PAC ID: 3173933892 Enrollment ID: I20241009003305 |
| Provider Name | Anusha Reddy Madadi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1447416334 PECOS PAC ID: 9133398126 Enrollment ID: I20241108001566 |
| Provider Name | Layne Bracy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780660464 PECOS PAC ID: 3476455429 Enrollment ID: I20241202001991 |
| Provider Name | Julien Succar |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1700220811 PECOS PAC ID: 8820345705 Enrollment ID: I20241217003778 |
| Provider Name | Shelley Lynn Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063235992 PECOS PAC ID: 2769919737 Enrollment ID: I20250102003422 |
| Provider Name | Hillary Wagner |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437579570 PECOS PAC ID: 1052733524 Enrollment ID: I20250122002178 |
| Provider Name | Phyllis Ager |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1962405456 PECOS PAC ID: 9032139373 Enrollment ID: I20250313003194 |
Cowlitz Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1057 12th Ave, Longview, WA 98632 Phone: 360-636-3892 Fax: 360-414-1114 | |
Providence Health & Services Oregon Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 971 11th Ave, Longview, WA 98632 Phone: 360-577-1771 | |
Longview Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 820 11th Ave, Longview, WA 98632 Phone: 360-423-6626 Fax: 360-423-6626 | |
Ideal Option, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1146 14th Ave, Longview, WA 98632 Phone: 877-522-1275 Fax: 509-491-3031 | |
Kidspace Therapy, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2145 Tibbetts Dr Ste A, Longview, WA 98632 Phone: 360-560-1972 Fax: 360-703-3452 | |
Cowlitz Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1057 12th Ave, Longview, WA 98632 Phone: 360-636-3892 Fax: 360-414-1114 | |
Convenient Physicians Services Ps Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1052 Douglas St, Longview, WA 98632 Phone: 360-425-5845 Fax: 360-577-9066 |