WHIDBEY MEDICAL CLINIC PLLC (NPI# 1548260177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548260177 |
| Entity Type | Organization |
| Organization Name | WHIDBEY MEDICAL CLINIC PLLC |
| Practice Address |
231 Se Barrington Dr Suite 209 Oak Harbor WA 98277-3200 |
| Practice Telephone | 3606793161 |
| Practice Fax Number | 3606791741 |
| Mailing Telephone | 3606793161 |
| Mailing Fax Number | 3606791741 |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2009-12-04 |
| Authorized Official Name | DR. ROBERT L LYCKSELL (OWNER) |
| Authorized Official Telephone | 3606793161 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | BLUE CROSS/SHIELD | S57923 | 01 |
| WA | RAILROAD MEDICARE | CC9056 | 01 |
| Street Address |
231 SE BARRINGTON DR SUITE 209 |
| City | OAK HARBOR |
| State | WA |
| Zip Code | 98277-3200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265058986 | Bryan Mcbrayer | Behavioral Analyst | 231 Se Barrington Dr, Oak Harbor, WA 98277-3200 | 2020-06-18 |
| 1578193207 | Jessica Nichole Adline Malone | Behavioral Analyst | 231 Se Barrington Dr, Oak Harbor, WA 98277-3200 | 2020-01-22 |
| 1609426592 | Olivia Fay Sundman | Behavior Technician | 231 Se Barrington Dr, Oak Harbor, WA 98277-3200 | 2019-09-12 |
| 1407404965 | Island of Hope Counseling Pllc | Counselor | 231 Se Barrington Dr, Oak Harbor, WA 98277-3200 | 2019-08-28 |
| 1093230260 | Brandon Boelter | Behavioral Analyst | 231 Se Barrington Dr, Oak Harbor, WA 98277-3200 | 2017-08-09 |
| 1972032332 | Iesha Shante Purvis | Behavioral Analyst | 231 Se Barrington Dr, Ste. 203, Oak Harbor, WA 98277-3200 | 2017-06-08 |
| 1558893925 | Michayla Starling | Behavioral Analyst | 231 Se Barrington Dr, Ste 203, Oak Harbor, WA 98277-3200 | 2017-04-03 |
| 1265971766 | Megan Ingram | Behavioral Analyst | 231 Se Barrington Dr, Suite 203, Oak Harbor, WA 98277-3200 | 2017-02-16 |
| 1740728427 | Jaclyn Michelle Townsend | Behavioral Analyst | 231 Se Barrington Dr, Suite 203, Oak Harbor, WA 98277-3200 | 2017-02-02 |
| 1568909299 | Kristi Rieker | Behavioral Analyst | 231 Se Barrington Dr, Suite 203, Oak Harbor, WA 98277-3200 | 2017-01-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952951782 | Amber Dorothy Rettus | Counselor | 31640 Wa -20 #1, Oak Harbor, WA 98277 | 2019-09-13 |
| 1528612082 | Grace Alfery Finnell | Pharmacist | 31645 Sr 20, Oak Harbor, WA 98277 | 2019-08-01 |
| 1407321839 | Leah Marie Threats | Behavior Technician | Advance Behavioral Education Continuum, 231 Se Barrington Dr. Ste 201, Oak Harbor, WA 98277 | 2018-10-12 |
| 1285115329 | Jared M Wirth | Dentist | 275 Se Cabot Dr., #b201, Oak Harbor, WA 98277 | 2018-08-27 |
| 1952896854 | Makella Ann Mccormack | Behavior Technician | 231 Se Barrington Dr. Ste 203, Oak Harbor, WA 98277 | 2018-06-25 |
| 1972004703 | Sophia Kaye Johnson | Counselor | 3165 Wa-20 Suite#1, Oak Harbor, WA 98277 | 2018-02-27 |
| 1043728827 | Lance D Keyes Dds | Dentist | 32650 State Route 20 Ste E106, Oak Harbor, WA 98277 | 2018-01-16 |
| 1689195075 | Laboratory Corporation of America | Clinical Medical Laboratory | 275 Se Cabot Dr Ste A9, Oak Harbor, WA 98277 | 2017-07-06 |
| 1841723368 | Stephanie Bailey | Behavioral Analyst | 231 Barrington Dr. Suite 201, Oak Harbor, WA 98277 | 2017-04-11 |
| 1336684463 | Angel Lyn Faith Camello | Behavior Technician | 31955 State Route 20, #3, Oak Harbor, WA 98277 | 2016-12-28 |
| Find all providers in zip 98277 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467497636 | Whidbey Island Public Hospital District | Clinic/Center | 1300 Ne Goldie St, Oak Harbor, WA 98277-4832 | 2006-06-19 |
| 1821632639 | Whidbey Island Public Hospital District | Clinic/Center | 1300 Ne Goldie St, Oak Harbor, WA 98277-4832 | 2019-11-05 |
| 1811451362 | Ideal Option, Pllc | Clinic/Center | 32650 State Route 20 Ste 108, Oak Harbor, WA 98277-2641 | 2019-01-29 |
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| 1942811211 | Little Fin Therapies, LLC | Clinic/Center | 5942 31st Ave Sw, Seattle, WA 98126-2910 | 2020-08-11 |
| 1578187829 | Therapy Northwest Pllc | Clinic/Center | 310 3rd Ave Ne Ste 124, Issaquah, WA 98027-3350 | 2020-06-02 |
| 1922621721 | Riaz Pllc | Clinic/Center | 8378 W Grandridge Blvd Ste 110, Kennewick, WA 99336-5401 | 2020-05-27 |
| 1295356848 | Community Health Care | Clinic/Center | 16329 Se 318th St, Auburn, WA 98092-9284 | 2020-05-05 |
| 1720617533 | Nova Mind-body LLC | Clinic/Center | 116 13th Ave E Apt 1e, Seattle, WA 98102-6142 | 2020-04-03 |
| 1609403054 | Lavender Luxe Massage | Clinic/Center | 100 3rd St Ste 100, Davenport, WA 99122-5008 | 2020-03-25 |
| 1417582255 | Personalized Health, LLC | Clinic/Center | 7136 Mlk Jr Way S Ste 204, Seattle, WA 98118-3526 | 2020-03-11 |
| 1912530932 | Lummi Indian Business Council | Clinic/Center | 2924 Haxton Way, Bellingham, WA 98226-9265 | 2020-02-18 |
| Find all providers with the same taxonomy | ||||
| City | OAK HARBOR |
| Zip Code | 98277 |
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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.