| Ppm Washington LLC | |
|
1370 Bridge St Clarkston WA 99403-2332 | |
| (208) 401-1400 | |
| Not Available |
| Full Name | Ppm Washington LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1370 Bridge St, Clarkston, Washington |
| Authorized Official Name and Position | Amber L Tueller (SECRETARY) |
| Authorized Official Contact | 2082072726 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppm Washington LLC 1675 E Riverside Dr Ste 200 Eagle ID 83616-7473 Ph: (208) 401-1400 | Ppm Washington LLC 1370 Bridge St Clarkston WA 99403-2332 Ph: (208) 401-1400 |
| NPI Number | 1568119204 |
|---|---|
| Provider Enumeration Date | 03/02/2022 |
| Last Update Date | 10/12/2026 |
| Certification Date | 10/12/2026 |
| Medicare PECOS PAC ID | 0941697569 |
|---|---|
| Medicare Enrollment ID | O20220429001538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568119204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Amy K Tierra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053658724 PECOS PAC ID: 4789984238 Enrollment ID: I20151204002262 |
| Provider Name | Celina M Georgia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225543622 PECOS PAC ID: 6406118389 Enrollment ID: I20180314000021 |
| Provider Name | Melanie Soper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184197568 PECOS PAC ID: 8527499771 Enrollment ID: I20220901000550 |
| Provider Name | D'arcy M Kaaua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871229369 PECOS PAC ID: 0941685192 Enrollment ID: I20220923001828 |
| Provider Name | Lisa Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912419243 PECOS PAC ID: 3870853724 Enrollment ID: I20230619001482 |
| Provider Name | Julie Ann Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407561962 PECOS PAC ID: 2769846880 Enrollment ID: I20230907003944 |
| Provider Name | David Christopher Free |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932460078 PECOS PAC ID: 6406006436 Enrollment ID: I20240614001017 |
| Provider Name | Tracy Streibick Flynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073983748 PECOS PAC ID: 4880904119 Enrollment ID: I20260116003364 |
Richard J. Weiland, Jr., M.D. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1207 Evergreen Ct, Clarkston, WA 99403 Phone: 509-758-0006 Fax: 509-758-2607 |
Healing Wings International PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1221 Highland Ave, Clarkston, WA 99403 Phone: 509-758-5511 |
Optimal Health and Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1267 Belmont Way, Clarkston, WA 99403 Phone: 509-780-1132 Fax: 509-758-8096 |
Larsen Gastroenterology, PLLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 625 6th St, Clarkston, WA 99403 Phone: 509-758-2200 |
Donald J. Greggain, M.D. PS Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1271 Highland Ave, Clarkston, WA 99403 Phone: 509-751-1500 Fax: 509-751-1504 |
Stat Med Solutions PC Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1221 Highland Ave, Clarkston, WA 99403 Phone: 509-758-5511 |