IDALIS RAE CALVERT


Address: 243511 W Highway 101, Port Angeles, WA 98363-9472
Phone: 3605657264

IDALIS RAE CALVERT (NPI# 1013422757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013422757
Entity Type Individual
Full Name IDALIS RAE CALVERT
Practice Address 243511 W Highway 101
Port Angeles
WA 98363-9472
Practice Telephone 3605657264
Practice Fax Number 3604526274
Mailing Telephone 3605657264
Mailing Fax Number 3604526274
Enumeration Date 2017-12-04
Last Update Date 2017-12-04
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2083P0901X Preventive Medicine
Specialization: Public Health & General Preventive Medicine
CG60769343 WA Allopathic & Osteopathic Physicians

Office Location

Street Address 243511 W HIGHWAY 101
City PORT ANGELES
State WA
Zip Code 98363-9472

Providers in the same location

NPI Name Taxonomy Address Enumeration
1376626069 Wendy Lynne Walsh Dentist 243511 W Highway 101, Port Angeles, WA 98363-9472 2006-10-24
1063071223 Lauren Steim Dentist 243511 W Highway 101, Port Angeles, WA 98363-9472 2019-06-11
1417469990 Marissa Alexandra Pratt Dietitian, Registered 243511 W Highway 101, Port Angeles, WA 98363-9472 2017-10-24
1366976201 January M Bourassa Naturopath 243511 W Highway 101, Port Angeles, WA 98363-9472 2017-04-18
1114470747 Sherry Churchill Nurse Practitioner 243511 W Highway 101, Port Angeles, WA 98363-9472 2016-08-01
1871954941 Andrea Blake Counselor 243511 W Highway 101, Port Angeles, WA 98363-9472 2016-03-16
1265834899 Lower Elwha Health Clinic Clinic/Center 243511 W Highway 101, Port Angeles, WA 98363-9472 2014-09-26
1205151388 Lower Elwha Maternal Support Services Case Manager/Care Coordinator 243511 W Highway 101, Port Angeles, WA 98363-9472 2010-04-01
1760687057 Deborah A Rokosz Family Medicine 243511 W Highway 101, Port Angeles, WA 98363-9472 2007-06-18
1023134988 Lower Elwha Klallam Tribe Dental Clinic Clinic/Center 243511 W Highway 101, Port Angeles, WA 98363-9472 2007-03-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164073185 Sandra Lier Technician 1064 Freshwater Park Rd., Port Angeles, WA 98363 2019-09-20
1053969451 Kari Ann Walen Physician Assistant 4407 Fairmont Ave, Port Angeles, WA 98363 2019-08-28
1407313059 Christina Chadick Counselor 243511 Hwy 101 W., Port Angeles, WA 98363 2019-03-01
1982198214 Serenity House of Clallam County Case Management 2203 W. 18th Street, Port Angeles, WA 98363 2018-06-20
1528564325 Katelynne Mcdaniels Behavior Technician 1915 West 5th St, Port Angeles, WA 98363 2018-04-02
1730574930 Vladislav Abaturov Nurse Practitioner 4407 Fairmont Avenue, Port Angeles, WA 98363 2015-04-03
1710314703 Allan M Steigerwald Anesthesiology 4217 South Bean Road, Port Angeles, WA 98363 2013-10-04
1033431010 Jean Leslie Kruger Counselor 3080 Lower Elwha Road, Port Angeles, WA 98363 2010-02-18
1518297001 John Robert Zey General Practice 601 Diamond Vista Drive, Port Angeles, WA 98363 2010-01-05
1043540651 Connie Lou Landrum General Practice 641 Diamond Vista Dr, Port Angeles, WA 98363 2010-01-04
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Taxonomy Information

Taxonomy Code 2083P0901X
Grouping Allopathic & Osteopathic Physicians
Classification Preventive Medicine
Specialization Public Health & General Preventive Medicine

Taxonomy Definition

Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1750342770 Thomas Henry Locke Preventive Medicine 223 E 4th St, Ste 14, Port Angeles, WA 98362-3015 2006-03-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1851840508 Kimquy Kieu Preventive Medicine 711 24th Ave S, Seattle, WA 98144-3003 2016-09-22
1659799443 James Kublin Preventive Medicine 1100 Fairview Ave N # E3-300, Seattle, WA 98109-4433 2014-03-31
1679918031 Richard L. Rysdam Preventive Medicine 4742 42nd Ave Sw # 292, Seattle, WA 98116-4553 2013-04-29
1275886533 Ashley Hedeen Preventive Medicine 1400 N 143rd St, Seattle, WA 98133-7102 2012-10-23
1821354069 Aristotle Sun Preventive Medicine 3915 Talbot Rd S Ste 104, Renton, WA 98055-5738 2012-04-02
1760756563 Reimert Thorolf Ravenholt Preventive Medicine 3156 E Laurelhurst Dr Ne, Seattle, WA 98105-5333 2012-02-27
1124316641 Steven Dale Helgerson Preventive Medicine 601 Belmont Ave E, Suite F11, Seattle, WA 98102-4875 2011-07-18
1194054247 Lewis B Rock IIi Preventive Medicine 2375 30th Ave Ne, Issaquah, WA 98029-3618 2009-12-21
1609047810 Paul Howard Stepak Preventive Medicine 15300 Bothell Way Ne, Lake Forest Park, WA 98155-7634 2008-03-14
1326253501 Kristin Elise Erickson Preventive Medicine 9040 Jackson Ave Medical Evaluation Board, Tacoma, WA 98431-0001 2007-05-11
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Competitor

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City PORT ANGELES
Zip Code 98363

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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