PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC (NPI# 1063646107) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063646107 |
| Entity Type | Organization |
| Organization Name | PULLMAN REGIONAL HOSPITAL CLINIC NETWORK LLC |
| Other Organization Name | PALOUSE PEDIATRICS - PULLMAN |
| Practice Address |
1205 Se Pro Mall Blvd Ste 104 Pullman WA 99163-5423 |
| Mailing Address |
840 Se Bishop Blvd Ste 101 Pullman WA 99163-5502 |
| Practice Telephone | 5093326139 |
| Practice Fax Number | 5093326579 |
| Mailing Telephone | 5093326139 |
| Mailing Fax Number | 5093326579 |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2017-09-20 |
| Authorized Official Name | STEVEN FEBUS (CFO) |
| Authorized Official Telephone | 5093326139 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | WA | Allopathic & Osteopathic Physicians | |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
WA | Allopathic & Osteopathic Physicians | |
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
50-3922 | WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | MEDICARE PTAN | G8891113 | 01 |
| WA | CMS CERTIFICATION | 50-3922 | 01 |
| Other Name | Type Code |
|---|---|
| Palouse Pediatrics - Pullman | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205104593 | Pullman Regional Hospital Clinic Network LLC | Pediatrics | 1420 S Blaine St Ste 5, Moscow, ID 83843-3973 | 2011-12-01 |
| Street Address |
1205 SE PRO MALL BLVD STE 104 |
| City | PULLMAN |
| State | WA |
| Zip Code | 99163-5423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003445255 | Jennifer Beattie | Specialist/Technologist | 1360 Cougar Way, Pullman, WA 99163 | 2020-04-08 |
| 1245715788 | Chirs Sader | Specialist/Technologist | Cougar Way, Bohler Addition, Pullman, WA 99163 | 2018-10-01 |
| 1588158307 | Stefanie Clark | Massage Therapist | 1205 Se Bishop Blvd, Suite #109, Pullman, WA 99163 | 2018-06-15 |
| 1023523859 | Madeleine Degrasse | Specialist/Technologist | 1580 Ne Cougar Way, 265, Coleman, WA 99163 | 2017-12-01 |
| 1720517188 | Chelsea Michelle Luna | Specialist/Technologist | 705 Nw State St, Pullman, WA 99163 | 2017-06-08 |
| 1649706185 | Travis Reid Edwards | Specialist/Technologist | 1455 Ne Colorado St, Pullman, WA 99163 | 2017-05-03 |
| 1053775403 | Anna Grindeland | Dietitian, Registered | 555 Se Water St, Pullman, WA 99163 | 2016-04-12 |
| 1487991741 | Yoko Jingi | Specialist/Technologist | 1225 S Grand Ave., Pullman, WA 99163 | 2013-01-07 |
| 1003151572 | Jessie M Armstrong | Speech-Language Pathologist | 1805 Nw Canyonview Drive, Pullman, WA 99163 | 2012-12-10 |
| 1679827877 | Schweitzer Engineering Laboratories | Clinic/Center | 2440 Ne Hopkins Ct., Pullman, WA 99163 | 2012-11-09 |
| Find all providers in zip 99163 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811555931 | Okanogan County Public Hospital Dist No 4 | Clinic/Center | 118 N Whitcomb Ave, Tonasket, WA 98855-8803 | 2019-06-04 |
| 1790204154 | Sunnyside Community Hospital Association | Clinic/Center | 715 N Park Ctr, Selah, WA 98942-1174 | 2017-09-15 |
| 1699215384 | Sunnyside Community Hospital Association | Clinic/Center | 505 W 4th Ave, Toppenish, WA 98948-1615 | 2017-03-01 |
| 1609112739 | Grant County Public Hospital District. No. 1 | Clinic/Center | 8420 Aspi Blvd, Moses Lake, WA 98837-1820 | 2012-12-18 |
| 1801188073 | Jefferson County Public Hospital District No 2 | Clinic/Center | 89 Breaker Ln, Port Ludlow, WA 98365-9766 | 2011-05-06 |
| 1255651907 | Family Care Network Pllc | Clinic/Center | 2511 M Ave Ste A, Anacortes, WA 98221-3897 | 2010-06-04 |
| 1871822676 | Public Hospital District 3 of Pacific County | Clinic/Center | 167 1st Avenue North, Ilwaco, WA 98624-0319 | 2009-12-08 |
| 1720276207 | Richard L. Dickson | Clinic/Center | 481 West E St, Forks, WA 98331 | 2007-10-09 |
| 1316138720 | L. Keith Hanson Pllc | Clinic/Center | 520 W. Indian Avenue, Brewster, WA 98812 | 2007-08-09 |
| 1407055742 | San Juan Healthcare PC | Clinic/Center | 689 Airport Center Dr Suite B, Friday Harbor, WA 98250 | 2007-07-17 |
| Find all providers with the same taxonomy | ||||
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| 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.