| Prudy Medical | |
|
6718 144th St Nw Gig Harbor WA 98332-8738 | |
| (253) 857-6166 | |
| Not Available |
| Full Name | Prudy Medical |
|---|---|
| Speciality | Family Medicine |
| Location | 6718 144th St Nw, Gig Harbor, Washington |
| Authorized Official Name and Position | Corrine Gallagher (OWNER) |
| Authorized Official Contact | 2538576166 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prudy Medical 6718 144th St Nw Gig Harbor WA 98332-8738 Ph: (253) 857-6166 | Prudy Medical 6718 144th St Nw Gig Harbor WA 98332-8738 Ph: (253) 857-6166 |
| NPI Number | 1790519015 |
|---|---|
| Provider Enumeration Date | 08/28/2024 |
| Last Update Date | 10/21/2024 |
| Certification Date | 10/21/2024 |
| Medicare PECOS PAC ID | 9032642459 |
|---|---|
| Medicare Enrollment ID | O20241023004868 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790519015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Paula a Constance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437175676 PECOS PAC ID: 8820075823 Enrollment ID: I20040707000405 |
| Provider Name | Michael D Wingren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760595664 PECOS PAC ID: 1759405822 Enrollment ID: I20100825001081 |
| Provider Name | Julia E Cathcart Chang |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174831440 PECOS PAC ID: 3274712187 Enrollment ID: I20140107001273 |
| Provider Name | Stephanie Lynne Shah |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639666118 PECOS PAC ID: 1658621792 Enrollment ID: I20180911001386 |
| Provider Name | Brandon Scott Weaver |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053632083 PECOS PAC ID: 6204176696 Enrollment ID: I20190321001477 |
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