TRACY L ESTRELLADO (NPI# 1083645733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083645733 |
Entity Type | Individual |
Full Name | TRACY L ESTRELLADO |
Credential | PA-C |
Practice Address |
840 E Hill Ave Moses Lake WA 98837-2238 |
Mailing Address |
820 N Chelan Ave Wenatchee WA 98801-2028 |
Practice Telephone | 5097650216 |
Enumeration Date | 2006-07-05 |
Last Update Date | 2014-02-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10002438 | WA | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | RR MEDICARE | P01257588 | 01 |
WA | L&I | 127396 | 01 |
WA | L&I POST 7/21/13 | 314838 | 01 |
WA | 1083645733 | 05 |
Street Address |
840 E HILL AVE |
City | MOSES LAKE |
State | WA |
Zip Code | 98837-2238 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275539256 | Kimberlee Elizabeth Poole | Nurse Practitioner | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2005-06-23 |
1366041188 | Breanne Mcintyre | Dietitian, Registered | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2020-10-22 |
1164036224 | Jennipher Colas | Physician Assistant | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2020-09-04 |
1609431709 | Andrew James Nielsen | Physician Assistant | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2019-05-03 |
1669931705 | Michael Johnson | Physician Assistant | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2019-03-18 |
1609340074 | Reaghan Kathleen Siebein | Nurse Practitioner | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2019-01-18 |
1578036315 | Rachel M Ebeling | Counselor | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2019-01-04 |
1891267951 | Darren Scott Trofibio | Nurse Practitioner | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2018-12-28 |
1083166813 | Braeden R Cook | Nurse Practitioner | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2016-10-27 |
1942650437 | Kelley L Drayer | Counselor | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2016-06-15 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316447097 | Lateef Ajani Olaniyan | Pharmacist | 2709 W Broadway Avenue, Southgate Pharmacy, Moses Lake, WA 98837 | 2018-02-19 |
1982117651 | Amanda M Cross | Massage Therapist | 2200 S. Maiers Rd., Suite B, Moses Lake, WA 98837 | 2017-11-15 |
1962928200 | E & H Holdings, LLC | Family Medicine | 708 E Penn St, Moses Lake, WA 98837 | 2017-08-18 |
1912366881 | Tara L Zamarron | Nurse Practitioner | 1550 S. Pioneer Way, Samaritan Family Physicians, Moses Lake, WA 98837 | 2016-02-19 |
1124401732 | Christian Mmadibuobu Okafor | Dentist | 605 South Coolidge Street, Moses Lake Community Health Center, Moses Lake, WA 98837 | 2015-06-30 |
1790182004 | Tari Ann Devaney | Dental Hygienist | 605 Coolidge Drive, Moses Lake, WA 98837 | 2014-12-02 |
1356746150 | Anna Marie Peterson | Counselor | 814 S. Wilder St., Moses Lake, WA 98837 | 2014-10-23 |
1699119495 | Geoffrey T. Ping D.d.s. and Asia Dela Cruz D.d.s. Pllc | Dentist | 800 N. Stratford Rd., Moses Lake, WA 98837 | 2013-04-23 |
1831433325 | George Kenyon Exeter | Physical Therapy Assistant | 817 E Plum Ave, Moses Lake, WA 98837 | 2012-11-21 |
1114219698 | Sound Oxygen Service Inc | Durable Medical Equipment & Medical Supplies | 1010 S Pioneer Way Ste C, Moses Lake, WA 98837 | 2011-05-03 |
Find all providers in zip 98837 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851471361 | Donna Gale Dabney | Physician Assistant | 605 S Coolidge Street, Moses Lake, WA 98837 | 2006-10-17 |
1427459874 | Brett A Greenburg | Physician Assistant | 605 S Coolidge St, Moses Lake, WA 98837-1893 | 2014-09-04 |
1588086664 | James Ewell | Physician Assistant | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2014-01-09 |
1750728788 | Casey Verl Woolsey | Physician Assistant | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2013-05-31 |
1508176751 | Arlene Patricia Johnson | Physician Assistant | 605 S Coolidge St, Moses Lake, WA 98837-1893 | 2010-10-20 |
1881902542 | Elizabeth Jean Reynolds | Physician Assistant | 840 E Hill Ave, Moses Lake, WA 98837-2238 | 2010-09-15 |
1669663597 | Allen D. Noble | Physician Assistant | 605 S Coolidge St, Moses Lake, WA 98837-1893 | 2007-08-06 |
1457574915 | John F Browne | Physician Assistant | 605 S Coolidge St, Moses Lake, WA 98837-1893 | 2007-04-11 |
1790865202 | Jodi O'shea | Physician Assistant | 605 S Coolidge St, Moses Lake, WA 98837-1893 | 2006-10-17 |
1336229152 | Eric Aronsohn | Physician Assistant | 605 S Coolidge St, Moses Lake, WA 98837-1893 | 2006-10-16 |
Find all providers in MOSES LAKE |
City | MOSES LAKE |
Zip Code | 98837 |
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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.