SAN JUAN HEALTHCARE PC (NPI# 1407055742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407055742 |
| Entity Type | Organization |
| Organization Name | SAN JUAN HEALTHCARE PC |
| Practice Address |
689 Airport Center Dr Suite B Friday Harbor WA 98250 |
| Mailing Address |
Po Box 1550 Friday Harbor WA 98250-1550 |
| Practice Telephone | 3603781338 |
| Practice Fax Number | 3603788130 |
| Mailing Telephone | 3603781338 |
| Mailing Fax Number | 3603781830 |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2011-03-04 |
| Authorized Official Name | JOHN BURK GOSSOM (OWNER) |
| Authorized Official Telephone | 3603781338 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | CLIA | 50D0990556 | 01 |
| WA | AETNA | 7990344 | 01 |
| WA | US CUSTOMAS & BORDER PROTECTION | 612622200 | 01 |
| WA | REGENCE | 9451SA | 01 |
| WA | LABOR AND INDUSTRIES | 0152516 | 01 |
| WA | 7138829 | 05 | |
| WA | MEDICARE | PENDING | 01 |
| WA | GROUP HEALTH COOPERATIVE | 748121 | 01 |
| WA | US NATL PARK SERVICE | 612622200 | 01 |
| WA | RAILROAD MEDICARE | POO425655DG2646 | 01 |
| WA | RAILROAD MEDICARE | J5122 | 01 |
| WA | DSHS | PENDING | 01 |
| WA | UBI | 602732862 | 01 |
| WA | PARKS NATL L&I | 361929500 | 01 |
| WA | CRIME VICTIMS | 8937841 | 01 |
| WA | 7135981 | 05 |
| Street Address |
689 AIRPORT CENTER DR SUITE B |
| City | FRIDAY HARBOR |
| State | WA |
| Zip Code | 98250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235642802 | Aileen Disney Howe | Occupational Therapist | 504 Fallingreen Way, Friday Harbor, WA 98250 | 2017-11-06 |
| 1255880217 | Bo Turnage Dds | Clinic/Center | 180 1st St, Ste 9, Friday Harbor, WA 98250 | 2016-09-30 |
| 1427452440 | Mt. Baker Planned Parenthood | Nurse Practitioner | 470 Reed Street, Unit 2a, Friday Harbor, WA 98250 | 2014-10-20 |
| 1851636211 | William Marvin Gaskill Sr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 17 Indian Beach Ln, Friday Harbor, WA 98250 | 2012-12-11 |
| 1275881831 | Freedom Enterprises Pllc | Clinic/Center | 180 First Street, #9, Friday Harbor, WA 98250 | 2012-08-29 |
| 1508129842 | Peacehealth Peace Island Medical Center | Emergency Medicine | 1117 Spring St., Friday Harbor, WA 98250 | 2012-06-21 |
| 1437468626 | Sarah Carlson | Speech-Language Pathologist | 505 Spring Street, Friday Harbor, WA 98250 | 2010-10-05 |
| 1164731113 | Lavendera Day Spa Ltd | Massage Therapist | 285 Spring Street, Friday Harbor, WA 98250 | 2010-09-24 |
| 1003124009 | Ciely Ti Gray | Massage Therapist | 440 Spring Street, Friday Harbor, WA 98250 | 2010-09-24 |
| 1881909950 | Karan Hannah | Speech-Language Pathologist | 599 High Haro Dr, Friday Harbor, WA 98250 | 2010-08-13 |
| Find all providers in zip 98250 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356326565 | San Juan Healthcare Associates Pllc | Clinic/Center | 689 Airport Center, Ste B, Friday Harbor, WA 98250 | 2005-12-09 |
| 1669010476 | Eventide Health Pllc | Clinic/Center | 689 Airport Center, Friday Harbor, WA 98250 | 2019-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992315808 | Vera Whole Health Wa, PC | Clinic/Center | 6700 Fort Dent Way Ste 100, Tukwila, WA 98188-2500 | 2020-08-05 |
| 1063037034 | Pioneer Family Medicine, Pllc | Clinic/Center | 20 E J St Ste 2b, Deer Park, WA 99006-8500 | 2020-06-15 |
| 1922622158 | Vera Whole Health Wa, PC | Clinic/Center | 16009 E Indiana Ave, Spokane Valley, WA 99216 | 2020-06-03 |
| 1578183729 | Family Care Network Pllc | Clinic/Center | 3548 Meridian St, Suite #101-b, Bellingham, WA 98225 | 2020-04-17 |
| 1548800451 | Vera Whole Health Wa PC | Clinic/Center | 1601 N Division St, Spokane, WA 99207-2427 | 2020-01-08 |
| 1821634312 | Columbia Basin Mobile Medicine LLC | Clinic/Center | 1357 Platinum Pl, West Richland, WA 99353-5108 | 2019-11-20 |
| 1063056497 | A Community Wellness Clinic LLC | Clinic/Center | 2405 E 17th Ave Ste 113, Spokane, WA 99223-5122 | 2019-10-29 |
| 1013550987 | Rejuventa Medical Corp. | Clinic/Center | 107 North Tower Ave Suite 17, Centralia, WA 98531-4253 | 2019-10-23 |
| 1023668407 | Vera Whole Health Wa, PC | Clinic/Center | 4933 Evergreen Way, Everett, WA 98203-2828 | 2019-09-17 |
| 1679042501 | Family and Wellness Medicine | Clinic/Center | 34004 16th Ave S Ste 100, Federal Way, WA 98003-8905 | 2018-11-20 |
| Find all providers with the same taxonomy | ||||
| City | FRIDAY HARBOR |
| Zip Code | 98250 |
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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.