| Mso Washington, Inc. | |
|
4901 108th St Sw Lakewood WA 98499-3724 | |
| (253) 984-7247 | |
| (253) 584-8916 |
| Full Name | Mso Washington, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 4901 108th St Sw, Lakewood, Washington |
| Authorized Official Name and Position | Charles Plunkett (PRESIDENT) |
| Authorized Official Contact | 2539847247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mso Washington, Inc. Po Box 98886 Lakewood WA 98496-8886 Ph: (253) 984-7247 | Mso Washington, Inc. 4901 108th St Sw Lakewood WA 98499-3724 Ph: (253) 984-7247 |
| NPI Number | 1891116109 |
|---|---|
| Provider Enumeration Date | 01/04/2014 |
| Last Update Date | 10/27/2020 |
| Medicare PECOS PAC ID | 1850292681 |
|---|---|
| Medicare Enrollment ID | O20040413001631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891116109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Victor Sobolewski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336158179 PECOS PAC ID: 5294744231 Enrollment ID: I20170201001284 |
| Provider Name | Ellen L Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538685110 PECOS PAC ID: 2769749647 Enrollment ID: I20171130003114 |
| Provider Name | Luis Eymard Javier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225409931 PECOS PAC ID: 3274833868 Enrollment ID: I20180731002005 |
| Provider Name | Mohsin Ikram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578015517 PECOS PAC ID: 1850678699 Enrollment ID: I20180809003004 |
| Provider Name | Kristyn Huffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982182788 PECOS PAC ID: 6507110764 Enrollment ID: I20181107001412 |
| Provider Name | Karen Davis Tosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609386226 PECOS PAC ID: 4789938671 Enrollment ID: I20190114000185 |
| Provider Name | Maria Socorro Miranda Gandara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366625717 PECOS PAC ID: 7315285905 Enrollment ID: I20190206000740 |
| Provider Name | Nancy Wairimu Minjire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457901555 PECOS PAC ID: 5294163093 Enrollment ID: I20200310000203 |
| Provider Name | Moira Kapeen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265982441 PECOS PAC ID: 9335568625 Enrollment ID: I20201006002709 |
| Provider Name | Ambreen Ahsan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124503313 PECOS PAC ID: 9537596663 Enrollment ID: I20201207002537 |
| Provider Name | Jane Tellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386250512 PECOS PAC ID: 9436542487 Enrollment ID: I20220215001775 |
| Provider Name | Mehreen Maryam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467178319 PECOS PAC ID: 3274902150 Enrollment ID: I20221215002539 |
| Provider Name | Taimur Ikram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437832565 PECOS PAC ID: 4284098633 Enrollment ID: I20230918004117 |
| Provider Name | Hazel Rose King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558905356 PECOS PAC ID: 1850720673 Enrollment ID: I20231206000312 |
| Provider Name | Judith Wangari Olepere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497213094 PECOS PAC ID: 3375884877 Enrollment ID: I20240223003335 |
| Provider Name | Saroja Buddhavarapu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558193847 PECOS PAC ID: 2264973031 Enrollment ID: I20240919002720 |
Community Health Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10510 Gravelly Lake Dr Sw, Lakewood, WA 98499 Phone: 253-589-7030 Fax: 253-597-4556 | |
Northwest Physicians Medical Group, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5920 100th St Sw Ste 31, Lakewood, WA 98499 Phone: 253-584-3023 Fax: 253-582-1222 | |
Avalon Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9315 Gravelly Lake Dr Sw, Suite 103, Lakewood, WA 98499 Phone: 253-582-8486 Fax: 253-582-2644 | |
Franciscan Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11311 Bridgeport Way Sw, Ste 100, Lakewood, WA 98499 Phone: 253-581-6688 Fax: 253-512-2894 | |
Franciscan Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5202 100th St Sw, Lakewood, WA 98499 Phone: 253-588-3670 Fax: 253-588-3703 | |
Hanmi Medical Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9115 S Tacoma Way Ste 105, Lakewood, WA 98499 Phone: 253-581-4564 Fax: 253-581-6484 | |
Asian American Chemical Dependency Treatment Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9102 Bridgeport Way Sw, Lakewood, WA 98499 Phone: 253-302-3826 Fax: 253-267-5212 |