GRETCHEN T WAMBACH (NPI# 1174555932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174555932 |
| Entity Type | Individual |
| Full Name | GRETCHEN T WAMBACH |
| Credential | PA-C |
| Practice Address |
565 Eureka Way Sequim WA 98382-5074 |
| Practice Telephone | 3605820808 |
| Practice Fax Number | 3606835678 |
| Mailing Telephone | 3605820808 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2011-07-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10004382 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | KPS | 80001669803 | 01 |
| WA | REGENCE | 6999WA | 01 |
| WA | PREMERA BLUE CROSS | 800016698 | 01 |
| WA | 8358285 | 05 | |
| WA | MEDICARE ID | AB38563 | 01 |
| Street Address |
565 EUREKA WAY |
| City | SEQUIM |
| State | WA |
| Zip Code | 98382-5074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144278441 | Valley Dermatology, Ps, Inc | Dermatology | 565 Eureka Way, Sequim, WA 98382-5074 | 2006-05-05 |
| 1932338506 | Heidi M Hermes Shantz | Dermatology | 565 Eureka Way, Sequim, WA 98382-5074 | 2009-07-04 |
| 1023104593 | Daniel W Walkowski | Physician Assistant | 565 Eureka Way, Sequim, WA 98382-5074 | 2006-10-04 |
| 1457309908 | Claire L Haycox | Dermatology | 565 Eureka Way, Sequim, WA 98382-5074 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760032841 | Dale I King | Technician | 512 Lostwood Lane, Sequim, WA 98382 | 2019-09-19 |
| 1831661164 | Katheryn Murray | Community Health Worker | 80 Spencer Rd Spc 10, Sequim, WA 98382 | 2018-12-27 |
| 1306314349 | Tera Joyce Phillips | Counselor | 112 S Solmar Dr, Sequim, WA 98382 | 2018-11-07 |
| 1275025595 | Peninsula Counseling | Social Worker | 435 West Bell St Suite D, Sequim, WA 98382 | 2018-06-01 |
| 1437661816 | Kathryn Elizabeth Sanford | Registered Nurse | 720 Carlsborg Rd, Sequim, WA 98382 | 2017-10-25 |
| 1407271935 | Hoa Lien Trinh | Denturist | 124 W. Spruce St., Sequim, WA 98382 | 2014-02-20 |
| 1306267323 | Pamela Hursey-king | Occupational Therapist | 600 West Hemlock St, Sequim, WA 98382 | 2013-12-17 |
| 1821419060 | Cortney Woodford | Speech-Language Pathologist | 600 West Hemlock Street, Sequim, WA 98382 | 2013-12-13 |
| 1851638043 | Sonja Ann Bittner | Registered Nurse | 503 North Sequim Ave, Sequim, WA 98382 | 2013-01-09 |
| 1063796175 | Peak Performance Therapy LLC | Occupational Therapist | 519 Eureka Way, Suite 2, Sequim, WA 98382 | 2011-10-07 |
| Find all providers in zip 98382 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831526359 | Silvia Maria Corzo | Physician Assistant | 522 N 5th Ave, Sequim, WA 98382-3079 | 2013-09-29 |
| 1538504774 | Pacific Primary Care - Sequim Inc | Physician Assistant | 800 N 5th Ave Ste 101, Sequim, WA 98382-3045 | 2013-05-01 |
| 1528362845 | Jenny Bendeck Michelet | Physician Assistant | 800 N 5th Ave, Suite # 101, Sequim, WA 98382-3045 | 2010-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033735618 | Gavin Guard | Physician Assistant | 818 Mullis St Ste 6, Friday Harbor, WA 98250-7986 | 2020-06-19 |
| 1578110862 | Kaitlin E. Brotman | Physician Assistant | 315 Holton Ave Ste 100, Yakima, WA 98902-3245 | 2019-08-21 |
| 1700345196 | Kara Lynn Kime | Physician Assistant | 1200 Cooper Point Rd Sw Ste 100, Olympia, WA 98502-1172 | 2019-03-15 |
| 1679056824 | Katharine Loco-marshall | Physician Assistant | 4816 She-nah-num Drive, Olympia, WA 98513 | 2018-09-13 |
| 1841791274 | Sjs, Pllc | Physician Assistant | 900 Ocean Beach Hwy Ste B, Longview, WA 98632-4013 | 2018-02-21 |
| 1063928448 | Heidi April | Physician Assistant | 1410 N Pittsburgh St, Building A, Kennewick, WA 99336-8211 | 2017-12-20 |
| 1194251983 | Christopher Joseph Stanley | Physician Assistant | 1010 Ne Lilac St Apt 301, Issaquah, WA 98029-7878 | 2017-05-11 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1801344601 | Jessica Ann Pettitt | Physician Assistant | 21200 Ne 190th Ct, Battle Ground, WA 98604-9636 | 2016-09-21 |
| 1407300098 | Joshua David Evans | Physician Assistant | 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 | 2016-08-11 |
| 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.