| South Island Primary And Immediate Care | |
|
1690 Layton Rd Freeland WA 98249-9456 | |
| (360) 678-6576 | |
| (360) 678-3970 |
| Full Name | South Island Primary And Immediate Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 1690 Layton Rd, Freeland, Washington |
| Authorized Official Name and Position | Mark Duncan (OWNER) |
| Authorized Official Contact | 3609294936 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Island Primary And Immediate Care 3145 Shadowbrook Ln Oak Harbor WA 98277-9031 Ph: (360) 929-4936 | South Island Primary And Immediate Care 1690 Layton Rd Freeland WA 98249-9456 Ph: (360) 678-6576 |
| NPI Number | 1043557333 |
|---|---|
| Provider Enumeration Date | 01/07/2013 |
| Last Update Date | 02/21/2013 |
| Medicare PECOS PAC ID | 4183860935 |
|---|---|
| Medicare Enrollment ID | O20130423000303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043557333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | MD60126180 (Washington) | Primary |
| Provider Name | Dan Eugene Fisher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548242928 PECOS PAC ID: 6800912833 Enrollment ID: I20100928000839 |
| Provider Name | Brook H Ott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336476233 PECOS PAC ID: 4486848546 Enrollment ID: I20101102001250 |
| Provider Name | Mark Duncan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598713919 PECOS PAC ID: 7719123561 Enrollment ID: I20130423000330 |
| Provider Name | Annette M Fly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134480056 PECOS PAC ID: 5193968378 Enrollment ID: I20130909000382 |
| Provider Name | Manuela Sabine Ziegler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417359472 PECOS PAC ID: 2769790815 Enrollment ID: I20181113003129 |
| Provider Name | Sajad Zalzala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639311509 PECOS PAC ID: 5092962209 Enrollment ID: I20220707002217 |
| Provider Name | Haley Maria Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598427619 PECOS PAC ID: 5395114193 Enrollment ID: I20221219001341 |
| Provider Name | Anna Edgecombe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497477129 PECOS PAC ID: 8426412602 Enrollment ID: I20230907001390 |
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