ELIZABETH BAGNULO DACEY (NPI# 1265799407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265799407 |
| Entity Type | Individual |
| Full Name | ELIZABETH BAGNULO DACEY |
| Credential | M.D. |
| Practice Address |
1225 Highland Avenue Clarkston WA 99403 |
| Mailing Address |
3810 Country Club Dr Lewiston ID 83501-9678 |
| Practice Telephone | 5097584652 |
| Mailing Telephone | 2088168361 |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2018-09-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
M-14192 | ID | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
MD60843598 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
1225 HIGHLAND AVENUE |
| City | CLARKSTON |
| State | WA |
| Zip Code | 99403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306409669 | Jessica Elaine Krull | Specialist/Technologist | 807 3rd Street, Clarkston, WA 99403 | 2019-04-22 |
| 1477006526 | Idaho County Rideshare | Non-emergency Medical Transport (VAN) | 1470 Elm Street, Clarkston, WA 99403 | 2016-07-25 |
| 1679921340 | Jonathan Preszler | Counselor | 629 6th Street, Educational and Psychological Services, Clarkston, WA 99403 | 2016-06-02 |
| 1104204957 | Optimal Health and Wellness | Clinic/Center | 1267 Belmont Way, Clarkston, WA 99403 | 2015-05-13 |
| 1326456351 | David Nygren | Pharmacist | 506 5th St, Clarkston, WA 99403 | 2014-07-22 |
| 1255672895 | Alpowa Healthcare, Inc. | Hospice Care, Community Based | 1370 Bridge Street, Clarkston, WA 99403 | 2013-03-06 |
| 1649586256 | Zeeshan Afzal | Internal Medicine | 1119 Highland Ave Ste 3, Clarkston, WA 99403 | 2010-08-20 |
| 1154657955 | Twin River Vision, Inc. | Optometrist | 306 5th Street, Clarkston, WA 99403 | 2009-10-29 |
| 1649429317 | Elizabeth Marie Allen-racicot | Specialist | 1013 Bridge Street, Clarkston, WA 99403 | 2008-09-17 |
| 1750405767 | Jennifer Altmiller Kaufman | Nurse Practitioner | 302 5th St, Ste 3, Clarkston, WA 99403 | 2007-03-16 |
| Find all providers in zip 99403 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316367857 | Paul Dennis Simonson | Pathology | Uwmc Anatomic Pathology, 1959 Ne Pacific, Box 356100, Seattle, WA 98195-0001 | 2014-04-23 |
| 1629413109 | Paula Marie Jenkins Colon | Pathology | Uw Medicine Pathology 1959 Ne Pacific St, Box 357470, Seattle, WA 98195-0001 | 2013-05-09 |
| 1104167550 | Pakc-dsl Inc Ps | Pathology | 550 17th Ave., Ste. 300, Seattle, WA 98122 | 2013-03-11 |
| 1295001436 | Robert Farrell Kapela | Pathology | 5652 132nd Ave Ne, Bellevue, WA 98005-1033 | 2012-03-30 |
| 1790051134 | Roberto Candelaria-santiago | Pathology | Mamc Dept of Pathology, 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1000 | 2012-03-29 |
| 1790070571 | Marc Omar Shokeir | Pathology | 336 36th St, 320, Bellingham, WA 98225-6580 | 2011-06-09 |
| 1801190186 | Malcolm Scott Stirton | Pathology | 6347 Beach Dr Sw, Seattle, WA 98136-1351 | 2010-12-31 |
| 1962721258 | John Fowler | Pathology | 9049 Jackson Ave, Tacoma, WA 98431-1000 | 2010-05-26 |
| 1063730745 | Bup-jong Jennifer Kum | Pathology | 1124 Columbia St # 8320, Seattle, WA 98104 | 2010-05-05 |
| 1770727638 | John Dallas Scarborough | Pathology | 2202 S Cedar St Ste 340, Tacoma, WA 98405-2318 | 2009-04-22 |
| 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.