| Pomeroy Medical Clinic | |
|
446 Pataha St Pomeroy WA 99347-8634 | |
| (509) 843-1491 | |
| (509) 843-1740 |
| Full Name | Pomeroy Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 446 Pataha St, Pomeroy, Washington |
| Authorized Official Name and Position | Brenda Parnell (CEO/SUPERINTENDENT) |
| Authorized Official Contact | 5098431591 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pomeroy Medical Clinic 66 N 6th St Pomeroy WA 99347-9705 Ph: (509) 843-1491 | Pomeroy Medical Clinic 446 Pataha St Pomeroy WA 99347-8634 Ph: (509) 843-1491 |
| NPI Number | 1114028693 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 07/25/2017 |
| Medicare PECOS PAC ID | 2668360769 |
|---|---|
| Medicare Enrollment ID | O20040309001450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114028693 | NPI | - | NPPES |
| 7105463 | Other | WA | MEDICA RURAL HEALTH ENCO |
| 7023161 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 503982 (Washington) | Primary |
| Provider Name | David T Jones |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922057454 PECOS PAC ID: 3678521796 Enrollment ID: I20080910000317 |
| Provider Name | Olympia Tachopoulou Stafford |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1740382670 PECOS PAC ID: 9032286745 Enrollment ID: I20080923000115 |
| Provider Name | Yongmoon A Park |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154334670 PECOS PAC ID: 3375526957 Enrollment ID: I20110425000579 |
| Provider Name | Courtney Travis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821419557 PECOS PAC ID: 9335362581 Enrollment ID: I20140516000309 |
| Provider Name | Morgan S Fife |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437405792 PECOS PAC ID: 1850546508 Enrollment ID: I20140613002282 |
| Provider Name | Christopher J Iacobelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649295866 PECOS PAC ID: 7618906934 Enrollment ID: I20150831001091 |
| Provider Name | Deborah Anne Fogg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558600015 PECOS PAC ID: 9739325259 Enrollment ID: I20170622000628 |
| Provider Name | Amber D Dacy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396247417 PECOS PAC ID: 5294160503 Enrollment ID: I20200115000038 |
| Provider Name | Melanie Hashagen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871060053 PECOS PAC ID: 4880935667 Enrollment ID: I20210112002923 |
| Provider Name | Marybella Dodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508513789 PECOS PAC ID: 1759758758 Enrollment ID: I20221103002926 |
| Provider Name | Camille Reyes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851796783 PECOS PAC ID: 3678946472 Enrollment ID: I20230227000155 |
| Provider Name | Alyson Redman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114120680 PECOS PAC ID: 9335232487 Enrollment ID: I20231113001686 |
Garfield County Hospital District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 66 6th St., Pomeroy, WA 99347 Phone: 509-843-1591 Fax: 509-843-1234 |