| Proctor Personal Md, Pllc | |
|
2517 N Washington St Tacoma WA 98406-5841 | |
| (253) 759-3586 | |
| (253) 759-5746 |
| Full Name | Proctor Personal Md, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2517 N Washington St, Tacoma, Washington |
| Authorized Official Name and Position | Lisa V Hamill (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2537593586 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Proctor Personal Md, Pllc 2517 N Washington St Tacoma WA 98406-5841 Ph: (253) 759-3586 | Proctor Personal Md, Pllc 2517 N Washington St Tacoma WA 98406-5841 Ph: (253) 759-3586 |
| NPI Number | 1649872680 |
|---|---|
| Provider Enumeration Date | 11/13/2020 |
| Last Update Date | 10/14/2021 |
| Medicare PECOS PAC ID | 8123431087 |
|---|---|
| Medicare Enrollment ID | O20210113003085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649872680 | NPI | - | NPPES |
| 1578655148 | Other | TYPE I NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lisa V Hamill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578655148 PECOS PAC ID: 3072642230 Enrollment ID: I20100526000423 |
| Provider Name | Paul W Pumilia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659454528 PECOS PAC ID: 0941370803 Enrollment ID: I20101213001029 |
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