| Wellpinit Indian Health | |
|
6203 Agency Loop Rd Wellpinit WA 99040-0357 | |
| (509) 258-4517 | |
| (509) 258-7152 |
| Full Name | Wellpinit Indian Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 6203 Agency Loop Rd, Wellpinit, Washington |
| Authorized Official Name and Position | Bill N Wiles (ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 5092584517 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellpinit Indian Health 6203 Agency Loop Road Po Box 357 Wellpinit WA 99040-0357 Ph: (509) 258-4517 | Wellpinit Indian Health 6203 Agency Loop Rd Wellpinit WA 99040-0357 Ph: (509) 258-4517 |
| NPI Number | 1316034580 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1850308313 |
|---|---|
| Medicare Enrollment ID | O20060308000863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316034580 | NPI | - | NPPES |
| 6021166 | Medicaid | WA | |
| 4926309 | Other | WA | PHARMACY NCPDP NUMBER |
| 7100407 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Thomasin K Hammer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528129798 PECOS PAC ID: 2567443989 Enrollment ID: I20050428000577 |
| Provider Name | Joseph P Santiago |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285667188 PECOS PAC ID: 1153466214 Enrollment ID: I20100301000959 |
| Provider Name | Leanne M Zilar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164575502 PECOS PAC ID: 9830281831 Enrollment ID: I20170125002516 |
| Provider Name | Diana Moser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154329555 PECOS PAC ID: 2769475623 Enrollment ID: I20200423000595 |
| Provider Name | Andrew J Trego |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053439331 PECOS PAC ID: 6103255443 Enrollment ID: I20200715003310 |
| Provider Name | Swapna Dutta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669133435 PECOS PAC ID: 2365834561 Enrollment ID: I20230302001043 |
| Provider Name | Aaron L Kime |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568486306 PECOS PAC ID: 8820984933 Enrollment ID: I20240223001657 |