| Tri-state Memorial Hospital | |
|
1221 Highland Ave Clarkston WA 99403-2829 | |
| (509) 758-5511 | |
| (509) 751-9406 |
| Full Name | Tri-state Memorial Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 1221 Highland Ave, Clarkston, Washington |
| Authorized Official Name and Position | Alex C Town (CFO) |
| Authorized Official Contact | 5097584667 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-state Memorial Hospital 1221 Highland Ave Clarkston WA 99403-2829 Ph: (509) 758-5511 | Tri-state Memorial Hospital 1221 Highland Ave Clarkston WA 99403-2829 Ph: (509) 758-5511 |
| NPI Number | 1598814352 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 07/05/2013 |
| Medicare PECOS PAC ID | 4082502422 |
|---|---|
| Medicare Enrollment ID | O20040308001123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598814352 | NPI | - | NPPES |
| 8K289 | Other | ID | BLUE CROSS OF IDAHO |
| 007032733 | Medicaid | WA | |
| 003111000 | Medicaid | ID | |
| 0082114 | Other | WA | LABOR AND INDUSTRIES |
| 000010142729 | Other | ID | REGENCE BLUE SHEILD |
| Provider Name | Onder Orgul |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1932123601 PECOS PAC ID: 2163320904 Enrollment ID: I20031230000630 |
| Provider Name | Ellen Elizabeth Halley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609965680 PECOS PAC ID: 7911891767 Enrollment ID: I20040211001174 |
| Provider Name | Robert Goldstein |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972693935 PECOS PAC ID: 2668450768 Enrollment ID: I20040713001153 |
| Provider Name | Wendi Rene Boyer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538101050 PECOS PAC ID: 9638140783 Enrollment ID: I20040803001178 |
| Provider Name | Mark William Peterson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356312524 PECOS PAC ID: 9830092857 Enrollment ID: I20040812001408 |
| Provider Name | John W Mannschreck |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942251376 PECOS PAC ID: 2466438205 Enrollment ID: I20050111000257 |
| Provider Name | Harold R Goldberg |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1497779334 PECOS PAC ID: 4486669496 Enrollment ID: I20060213000516 |
| Provider Name | Jennifer Collette Creaser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588772461 PECOS PAC ID: 6406853159 Enrollment ID: I20061023000308 |
| Provider Name | Lyndal E Stoutin |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1245240761 PECOS PAC ID: 1254326564 Enrollment ID: I20061026000649 |
| Provider Name | Craig George Flinders |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1760403893 PECOS PAC ID: 9133114440 Enrollment ID: I20061103000003 |
| Provider Name | Julius Szigeti |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225067069 PECOS PAC ID: 5092812008 Enrollment ID: I20070525000042 |
| Provider Name | Gary D Haas |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1912917618 PECOS PAC ID: 5698760908 Enrollment ID: I20070629000518 |
| Provider Name | Kenneth A Berger |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366407942 PECOS PAC ID: 5294768479 Enrollment ID: I20070706000497 |
| Provider Name | Dana D Martin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841464237 PECOS PAC ID: 4385723675 Enrollment ID: I20080512000716 |
| Provider Name | Byron E Wright |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972563930 PECOS PAC ID: 9234227141 Enrollment ID: I20080710000526 |
| Provider Name | Thao H Vu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891787453 PECOS PAC ID: 8527053016 Enrollment ID: I20090512000439 |
| Provider Name | Brian H Ngo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174743348 PECOS PAC ID: 8921144007 Enrollment ID: I20091002000268 |
| Provider Name | John G Peterson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1013931997 PECOS PAC ID: 2769572445 Enrollment ID: I20091027000207 |
| Provider Name | John Whitaker |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1013986249 PECOS PAC ID: 8729069885 Enrollment ID: I20110209000507 |
| Provider Name | Bryan J Phelps |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447598214 PECOS PAC ID: 5395981245 Enrollment ID: I20130418000561 |
| Provider Name | Sean Alan Spangler |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982679619 PECOS PAC ID: 5890936421 Enrollment ID: I20130724000872 |
| Provider Name | Nicole M Engledow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003248113 PECOS PAC ID: 9436385853 Enrollment ID: I20140822000611 |
| Provider Name | John Bradley Rudolph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548503022 PECOS PAC ID: 1759604309 Enrollment ID: I20150106001908 |
| Provider Name | Usama Sabzwari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811055684 PECOS PAC ID: 3072515584 Enrollment ID: I20150528000211 |
| Provider Name | Mark D Alter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730263617 PECOS PAC ID: 5991855330 Enrollment ID: I20150528001648 |
| Provider Name | Douglas M Ikelheimer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508979519 PECOS PAC ID: 1759347396 Enrollment ID: I20150529002621 |
| Provider Name | Dillon C Euler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396946554 PECOS PAC ID: 4587980446 Enrollment ID: I20150608002280 |
| Provider Name | Carson D Seeber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861740300 PECOS PAC ID: 0042530198 Enrollment ID: I20150701000789 |
| Provider Name | Rhonda R Lampen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760412621 PECOS PAC ID: 2163477308 Enrollment ID: I20150908001403 |
| Provider Name | Vilas Deshpande |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538157573 PECOS PAC ID: 1951578830 Enrollment ID: I20160106002177 |
| Provider Name | Richard Allan Callahan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215378336 PECOS PAC ID: 4587886221 Enrollment ID: I20160203001736 |
| Provider Name | Scott L Truman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811290760 PECOS PAC ID: 6507041449 Enrollment ID: I20160222001088 |
| Provider Name | Marissa L Stridiron |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154635811 PECOS PAC ID: 2668664251 Enrollment ID: I20160303002687 |
| Provider Name | Elton J Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679526784 PECOS PAC ID: 1759487614 Enrollment ID: I20160602000997 |
| Provider Name | Leroy C Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700830601 PECOS PAC ID: 6305755760 Enrollment ID: I20160615002414 |
| Provider Name | Chad Ficek |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629324793 PECOS PAC ID: 8527374289 Enrollment ID: I20161018002377 |
| Provider Name | Karl D Johnson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1861832818 PECOS PAC ID: 9638474851 Enrollment ID: I20170328001093 |
| Provider Name | Keith J Popovich |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1467483412 PECOS PAC ID: 9032013172 Enrollment ID: I20170420001422 |
| Provider Name | Iris Fadlon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346539202 PECOS PAC ID: 6709196447 Enrollment ID: I20170428001049 |
| Provider Name | Kimberley Blewett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306038997 PECOS PAC ID: 4688768831 Enrollment ID: I20170511001190 |
| Provider Name | Nicole Dirienzo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316151632 PECOS PAC ID: 2163556887 Enrollment ID: I20170805000140 |
| Provider Name | Matthew J Niedzwiecki |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174859284 PECOS PAC ID: 4183866981 Enrollment ID: I20180116001876 |
| Provider Name | Aaron A Dorcy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679935001 PECOS PAC ID: 6002176567 Enrollment ID: I20180201002899 |
| Provider Name | Miles F Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962859272 PECOS PAC ID: 7113217449 Enrollment ID: I20180208001904 |
| Provider Name | Beth Ann Monsebroten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336495407 PECOS PAC ID: 8325291693 Enrollment ID: I20180509003104 |
| Provider Name | Craig William Calhoun |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457325367 PECOS PAC ID: 9234208653 Enrollment ID: I20180814003867 |
| Provider Name | Leif P Kanooth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427338136 PECOS PAC ID: 5395960868 Enrollment ID: I20180823002302 |
| Provider Name | Patrick R Klempel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790942241 PECOS PAC ID: 5597806323 Enrollment ID: I20181219002986 |
| Provider Name | Jennifer B Jiru |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073005393 PECOS PAC ID: 8325383219 Enrollment ID: I20181220003338 |
| Provider Name | Elina Chernyak |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1710110820 PECOS PAC ID: 4082877899 Enrollment ID: I20190410002835 |
| Provider Name | Nicholas G Phillips |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720406291 PECOS PAC ID: 5092933408 Enrollment ID: I20190523001461 |
| Provider Name | James J Onorato |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1679504559 PECOS PAC ID: 5991768210 Enrollment ID: I20190705001143 |
| Provider Name | John F Merrill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992152326 PECOS PAC ID: 6103112339 Enrollment ID: I20190918000812 |
| Provider Name | Talmadge C Caviness |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497870091 PECOS PAC ID: 2567596794 Enrollment ID: I20191209000221 |
| Provider Name | Mick A Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487295531 PECOS PAC ID: 3274967799 Enrollment ID: I20191216002282 |
| Provider Name | Nicholas B Hardin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265774954 PECOS PAC ID: 3375884836 Enrollment ID: I20200211002850 |
| Provider Name | Paul Joseph Sanchirico |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750465514 PECOS PAC ID: 3375553860 Enrollment ID: I20200320001310 |
| Provider Name | Celso R Chavez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386795565 PECOS PAC ID: 1254320252 Enrollment ID: I20200413001733 |
| Provider Name | Cody B Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992081467 PECOS PAC ID: 1557529526 Enrollment ID: I20200413003661 |
| Provider Name | Cheryl A Loetscher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689766834 PECOS PAC ID: 4789685025 Enrollment ID: I20200415001091 |
| Provider Name | James Barclay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164468393 PECOS PAC ID: 6103809017 Enrollment ID: I20200427000754 |
| Provider Name | Joel Woodruff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912420332 PECOS PAC ID: 3971874421 Enrollment ID: I20200702002165 |
| Provider Name | Gregory R Spurling |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568464493 PECOS PAC ID: 9739273319 Enrollment ID: I20200708001522 |
| Provider Name | Karl G Spens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922305770 PECOS PAC ID: 2264614643 Enrollment ID: I20200708002841 |
| Provider Name | Austin Patrick Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649718610 PECOS PAC ID: 7517235328 Enrollment ID: I20200708002959 |
| Provider Name | Dallen B Ashby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851555478 PECOS PAC ID: 8325192982 Enrollment ID: I20200709000835 |
| Provider Name | Michael T Burtis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396765335 PECOS PAC ID: 9830405281 Enrollment ID: I20200731000944 |
| Provider Name | Jessica Erin Bringman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861024689 PECOS PAC ID: 8729492640 Enrollment ID: I20210203002494 |
| Provider Name | Roy M Bak |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1225046352 PECOS PAC ID: 7719032135 Enrollment ID: I20210219000605 |
| Provider Name | Thomas Owen Markel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639144728 PECOS PAC ID: 3173560661 Enrollment ID: I20210720003593 |
| Provider Name | Nicholas Carey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033613054 PECOS PAC ID: 0547511610 Enrollment ID: I20210805001422 |
| Provider Name | Megan Randall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629747829 PECOS PAC ID: 8325445000 Enrollment ID: I20210922002832 |
| Provider Name | Robert M Douglas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366532236 PECOS PAC ID: 4284721143 Enrollment ID: I20211007002883 |
| Provider Name | Hetal Brahmbhatt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841283199 PECOS PAC ID: 7012958580 Enrollment ID: I20211129001261 |
| Provider Name | Brandon L Whitlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124353719 PECOS PAC ID: 9436572740 Enrollment ID: I20211214002643 |
| Provider Name | Nancy K Koster |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073571741 PECOS PAC ID: 9234141201 Enrollment ID: I20211216000404 |
| Provider Name | Jonathan D Woolery |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891959730 PECOS PAC ID: 8527134162 Enrollment ID: I20220114001092 |
| Provider Name | Laure M Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154086429 PECOS PAC ID: 9739574260 Enrollment ID: I20220321001770 |
| Provider Name | Duncan D Harris |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679528632 PECOS PAC ID: 9133146236 Enrollment ID: I20220812002193 |
| Provider Name | Chad William Guthrie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912397969 PECOS PAC ID: 6406172923 Enrollment ID: I20220829001538 |
| Provider Name | James M Obermeyer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215241674 PECOS PAC ID: 0042459380 Enrollment ID: I20220831001593 |
| Provider Name | Erin A Mickelson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093106338 PECOS PAC ID: 0143536177 Enrollment ID: I20220831003990 |
| Provider Name | Ashley Jillane Read |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194306563 PECOS PAC ID: 9234532508 Enrollment ID: I20220916000101 |
| Provider Name | Monica Cespedes Santana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114204161 PECOS PAC ID: 7214212653 Enrollment ID: I20221013003381 |
| Provider Name | Maria Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841209194 PECOS PAC ID: 1759336175 Enrollment ID: I20221103002915 |
| Provider Name | Mary Fahrmeier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245252303 PECOS PAC ID: 4880657527 Enrollment ID: I20221114001491 |
| Provider Name | Lauren Prest |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881012235 PECOS PAC ID: 3971804147 Enrollment ID: I20221125000209 |
| Provider Name | Jeremiah Brewer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679968697 PECOS PAC ID: 8426366378 Enrollment ID: I20221207003154 |
| Provider Name | Bojana Jovanovic |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1962781807 PECOS PAC ID: 7911289673 Enrollment ID: I20230210000854 |
| Provider Name | Harbrinder Sandhu |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1902080625 PECOS PAC ID: 3072683507 Enrollment ID: I20230417001280 |
| Provider Name | Yamen Homsi |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1598052581 PECOS PAC ID: 5597988345 Enrollment ID: I20230502002431 |
| Provider Name | Sujata Sarkar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1194800607 PECOS PAC ID: 0547223786 Enrollment ID: I20230504001861 |
| Provider Name | Gregory L Wallis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790308278 PECOS PAC ID: 8628464096 Enrollment ID: I20230711003079 |
| Provider Name | Andrew F Vasconcellos |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1649518317 PECOS PAC ID: 0042502692 Enrollment ID: I20230720001720 |
| Provider Name | Lee Andrew Replogle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750739371 PECOS PAC ID: 1658614243 Enrollment ID: I20230901003673 |
| Provider Name | Laura P Edgerley-gibb |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205024361 PECOS PAC ID: 6608069216 Enrollment ID: I20230913002265 |
| Provider Name | Daniel Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598393902 PECOS PAC ID: 9436579794 Enrollment ID: I20230913004167 |
| Provider Name | Daniel Ryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598393902 PECOS PAC ID: 9436579794 Enrollment ID: I20230914000938 |
| Provider Name | Thomas Czajkowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710220595 PECOS PAC ID: 5698907939 Enrollment ID: I20230925001231 |
| Provider Name | Nora Ekeanya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154749844 PECOS PAC ID: 8628370467 Enrollment ID: I20230928001923 |
| Provider Name | John A Guilliot |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245499730 PECOS PAC ID: 9739214636 Enrollment ID: I20231008000196 |
| Provider Name | Ryan Joseph Daly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356124432 PECOS PAC ID: 0749635985 Enrollment ID: I20231009002039 |
| Provider Name | Julia M Hypes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598431942 PECOS PAC ID: 0840645099 Enrollment ID: I20231009002403 |
| Provider Name | Tayler Lyndsey Holman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093590580 PECOS PAC ID: 8325493489 Enrollment ID: I20231009003397 |
| Provider Name | Samuel Grossman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518499177 PECOS PAC ID: 7012338213 Enrollment ID: I20231018001820 |
| Provider Name | Ajit Chary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396184214 PECOS PAC ID: 0143453043 Enrollment ID: I20231020000235 |
| Provider Name | Hannah K Bancroft |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033824784 PECOS PAC ID: 5193190569 Enrollment ID: I20231107002712 |
| Provider Name | Akinyinka Abidem Ajelabi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841227808 PECOS PAC ID: 8729044789 Enrollment ID: I20231109003141 |
| Provider Name | Abby Fredrickson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376063370 PECOS PAC ID: 0547685125 Enrollment ID: I20231114000445 |
| Provider Name | Todd K Mcallister |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164652319 PECOS PAC ID: 4981742673 Enrollment ID: I20231118000313 |
| Provider Name | Jose Maria Ochoa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144548876 PECOS PAC ID: 5193952299 Enrollment ID: I20231121000892 |
| Provider Name | Irina Bratan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114567922 PECOS PAC ID: 9436576402 Enrollment ID: I20231122003111 |
| Provider Name | Peter Byers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477796936 PECOS PAC ID: 0547417651 Enrollment ID: I20231221002484 |
| Provider Name | Sirjana Pun |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093584732 PECOS PAC ID: 1254783574 Enrollment ID: I20240122004158 |
| Provider Name | Dezirae Berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740994268 PECOS PAC ID: 7810356441 Enrollment ID: I20240131002415 |
| Provider Name | Bhuvin Buddhdev |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1881907681 PECOS PAC ID: 7315195641 Enrollment ID: I20240209002173 |
| Provider Name | Charles De Jesus Morales |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710388681 PECOS PAC ID: 2365801339 Enrollment ID: I20240213003729 |
| Provider Name | James Lee Hug |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962015149 PECOS PAC ID: 7618395815 Enrollment ID: I20240216002712 |
| Provider Name | Arion Lochner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023578200 PECOS PAC ID: 2769864065 Enrollment ID: I20240219003175 |
| Provider Name | Amanda Lott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629847405 PECOS PAC ID: 8123462827 Enrollment ID: I20240221002936 |
Richard J. Weiland, Jr., M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1207 Evergreen Ct, Clarkston, WA 99403 Phone: 509-758-0006 Fax: 509-758-2607 | |
Healing Wings International Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1221 Highland Ave, Clarkston, WA 99403 Phone: 509-758-5511 | |
Optimal Health And Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1267 Belmont Way, Clarkston, WA 99403 Phone: 509-780-1132 Fax: 509-758-8096 | |
Larsen Gastroenterology, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 625 6th St, Clarkston, WA 99403 Phone: 509-758-2200 | |
Donald J. Greggain, M.d. Ps Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1271 Highland Ave, Clarkston, WA 99403 Phone: 509-751-1500 Fax: 509-751-1504 | |
Stat Med Solutions Pc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1221 Highland Ave, Clarkston, WA 99403 Phone: 509-758-5511 | |
Gage Inpatient Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1221 Highland Ave, Clarkston, WA 99403 Phone: 208-799-5522 |