LEAH W. BROCKWAY (NPI# 1134113905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134113905 |
| Entity Type | Individual |
| Full Name | LEAH W. BROCKWAY |
| Credential | MD |
| Practice Address |
92 Medical Group/ Flight Medicine Clinic 700 Hospital Loop, Bldg 9000 Fairchild Afb WA 99011 |
| Mailing Address |
1614 S Lincoln St Spokane WA 99203-1053 |
| Practice Telephone | 5092475755 |
| Practice Fax Number | 5092478833 |
| Mailing Telephone | 5099953307 |
| Mailing Fax Number | 5097474234 |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2008-02-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 5279439-1205 | UT | Allopathic & Osteopathic Physicians |
| Y | 2083A0100X |
Preventive Medicine Specialization: Aerospace Medicine |
MD00041103 | WA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 17373 | LA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 11633 | AL | Allopathic & Osteopathic Physicians |
| Street Address |
92 MEDICAL GROUP/ FLIGHT MEDICINE CLINIC 700 HOSPITAL LOOP, BLDG 9000 |
| City | FAIRCHILD AFB |
| State | WA |
| Zip Code | 99011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669939732 | Ruth Ann Sunde | Social Worker | 92d Medical Group/sgow, 701 Hospital Loop, Suite 259, Fairchild Afb, WA 99011 | 2019-02-26 |
| 1164992491 | Michael Thomas Stevens | Military Health Care Provider | 100 Hospital Loop, Fairchild Afb, WA 99011 | 2018-11-29 |
| 1174032569 | Elizabeth Andrews | Registered Nurse | 400 W Fairchild Highway, Fairchild Afb, WA 99011 | 2017-09-28 |
| 1770031171 | Mariah Combs | Behavioral Analyst | 5298 B Sycamore Street, Fairchild Afb, WA 99011 | 2016-09-14 |
| 1770960957 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 101 W. Spaatz Rd., Bldg 2465, Fairchild Afb, WA 99011 | 2015-04-27 |
| 1306191689 | Patricia Kaye Catrow | Family Medicine | 701 Hospital Loop Bldg 9000, Fairchild Afb, WA 99011 | 2012-07-23 |
| 1205102761 | 92nd Medical Group | Military/U.S. Coast Guard Pharmacy | 103 Saatz Rd, Fairchild Afb, WA 99011 | 2012-03-29 |
| 1992078554 | Alyssa Marie Degeyter | Community Health Worker | 7272 A Nebraska Ave, Fairchild Air Force Base, WA 99011 | 2012-02-13 |
| 1730317728 | Nicholas James Graham | Military Health Care Provider | 2504 S.chicago St, Fairchild Afb, WA 99011 | 2009-06-29 |
| 1922232099 | Pocco S Bussey | Military Health Care Provider | 92 Medical Group, Flight Medicine Clinic, Fairchild, WA 99011 | 2009-05-05 |
| Find all providers in zip 99011 | ||||
| Taxonomy Code | 2083A0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Aerospace Medicine |
| Aerospace medicine focuses on the clinical care, research, and operational support of the health, safety, and performance of crewmembers and passengers of air and space vehicles, together with the support personnel who assist operation of such vehicles. This population often works and lives in remote, isolated, extreme, or enclosed environments under conditions of physical and psychological stress. Practitioners strive for an optimal human-machine match in occupational settings rich with environmental hazards and engineering countermeasures. |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619961505 | Robert Joshua Grant | Preventive Medicine | 601 Hospital Loop, Fairchild Afb, WA 99011 | 2005-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538431721 | William Michael Waring | Preventive Medicine | 4127 Sw Kenyon St, Seattle, WA 98136-2332 | 2012-02-02 |
| 1033442298 | Gary Lee Henriksen | Preventive Medicine | 362 Greywolf Rd, Sequim, WA 98382-7574 | 2009-09-04 |
| 1174609341 | James Glazebrook Billingsley | Preventive Medicine | 1901 S Union, Tacoma, WA 98405 | 2006-10-31 |
| 1861582140 | Murl Edwin Leibrecht | Preventive Medicine | 578 Michael Way, Camano Island, WA 98282-8464 | 2006-10-15 |
| 1447343967 | Timothy J Ungs | Preventive Medicine | 6626 Chapel Hill Blvd Apt L104, Pasco, WA 99301-3880 | 2006-10-02 |
| 1639115892 | Harry Quigg Davis IIi | Preventive Medicine | Madiagn Army Medical Center, Mchj-fp (avn Med), Tacoma, WA 98431-0001 | 2006-06-22 |
| 1851356133 | Paul J Amoroso | Preventive Medicine | Credententials Office Madigan Army Medical Ctr, 9040 Fitzsimons Drive, Attn: Mchj-ci, Tacoma, WA 98431-0001 | 2006-04-19 |
| 1588638787 | Richard John Montminy | Preventive Medicine | 4320 196th St Sw Ste D, Us Healthworks Medical Group, Lynnwood, WA 98036-6753 | 2006-02-14 |
| 1447230123 | Nicholas Antony Davenport | Preventive Medicine | 1465 Scurlock Ln, Mukilteo, WA 98275-1734 | 2006-01-19 |
| 1477539989 | Jamin T Mcmahon | Preventive Medicine | 7811 Reliance Ridge Ln, Gig Harbor, WA 98335-1196 | 2005-12-16 |
| Find all providers with the same taxonomy | ||||
| City | FAIRCHILD AFB |
| Zip Code | 99011 |
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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.