| Pullman Readycare | |
|
825 Se Bishop Blvd Ste 200 Pullman WA 99163-5537 | |
| (509) 332-2517 | |
| (509) 334-9247 |
| Full Name | Pullman Readycare |
|---|---|
| Speciality | Family Medicine |
| Location | 825 Se Bishop Blvd Ste 200, Pullman, Washington |
| Authorized Official Name and Position | Stephanie M Fosback (PRESIDENT) |
| Authorized Official Contact | 5093322517 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pullman Readycare 825 Se Bishop Blvd Ste 200 Pullman WA 99163-5537 Ph: (509) 332-2517 | Pullman Readycare 825 Se Bishop Blvd Ste 200 Pullman WA 99163-5537 Ph: (509) 332-2517 |
| NPI Number | 1548299696 |
|---|---|
| Provider Enumeration Date | 07/01/2006 |
| Last Update Date | 08/17/2023 |
| Medicare PECOS PAC ID | 7618863358 |
|---|---|
| Medicare Enrollment ID | O20040227000496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548299696 | NPI | - | NPPES |
| 7085418 | Medicaid | WA | |
| 003202800 | Medicaid | ID |
| Provider Name | Richard Howe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871566679 PECOS PAC ID: 0446221337 Enrollment ID: I20040804000504 |
| Provider Name | Benno Mohr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275515058 PECOS PAC ID: 0840265005 Enrollment ID: I20040831000942 |
| Provider Name | Leslie Jean Robison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861584328 PECOS PAC ID: 8527017615 Enrollment ID: I20050114000808 |
| Provider Name | Nancy S Gregory |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801954003 PECOS PAC ID: 6305929704 Enrollment ID: I20080208000040 |
| Provider Name | Stephanie M Fosback |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760591622 PECOS PAC ID: 5698828846 Enrollment ID: I20090805000402 |
| Provider Name | Stephen P Hall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740211184 PECOS PAC ID: 1658565965 Enrollment ID: I20101101000602 |
| Provider Name | Dennis L Simpson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316979644 PECOS PAC ID: 2365469640 Enrollment ID: I20101101000892 |
| Provider Name | Christopher J Iacobelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649295866 PECOS PAC ID: 7618906934 Enrollment ID: I20150831001091 |
| Provider Name | Brenna R Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326482332 PECOS PAC ID: 7012137896 Enrollment ID: I20180227002701 |
| Provider Name | Kassandra M Tricola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922411834 PECOS PAC ID: 8426372251 Enrollment ID: I20180302001800 |
| Provider Name | Richard Lee Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396218491 PECOS PAC ID: 3971841149 Enrollment ID: I20190213001776 |
| Provider Name | Justin S Lytle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235636853 PECOS PAC ID: 6406100049 Enrollment ID: I20220406000145 |
| Provider Name | Clara E Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902433873 PECOS PAC ID: 9436513157 Enrollment ID: I20230914000915 |
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