L KEITH HANSON PLLC (NPI# 1588623581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588623581 |
| Entity Type | Organization |
| Organization Name | L KEITH HANSON PLLC |
| Other Organization Name | COMMUNITY MEDICAL CENTER |
| Practice Address |
520 W Indian Ave Brewster WA 98812 |
| Mailing Address |
Po Box 337 Brewster WA 98812-0337 |
| Practice Telephone | 5096892525 |
| Practice Fax Number | 5096893247 |
| Mailing Telephone | 5096892525 |
| Mailing Fax Number | 5096893247 |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2008-08-19 |
| Authorized Official Name | MELODIE WHITE (ADMINISTRATOR) |
| Authorized Official Telephone | 5096892525 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
503894 | WA | Ambulatory Health Care Facilities |
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7124779 | 05 |
| Other Name | Type Code |
|---|---|
| Community Medical Center | Former Legal Business Name - Organization |
| Street Address |
520 W INDIAN AVE |
| City | BREWSTER |
| State | WA |
| Zip Code | 98812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174043384 | Victoria Malloch Desalvo | Nurse Practitioner | 520 W Indian Ave, Brewster, WA 98812 | 2017-06-20 |
| 1710328869 | Jamie R Descoteaux | Nurse Practitioner | 520 W Indian Ave, Brewster, WA 98812 | 2013-07-17 |
| 1821340092 | Family Health Centers | Clinic/Center | 520 W Indian Ave, Brewster, WA 98812 | 2012-10-11 |
| 1316123581 | Caribou Trail Professional Medical Group | Orthopaedic Surgery | 520 W Indian Ave, Brewster, WA 98812-0220 | 2008-01-17 |
| 1417099391 | Jean Ann Ekvall | Dietitian, Registered | 520 W Indian Ave, Brewster, WA 98812 | 2007-02-13 |
| 1235190380 | Greg L Ledgerwood | Allergy & Immunology | 520 W Indian Ave, Brewster, WA 98812 | 2006-03-29 |
| 1023077922 | Lindsay Keith Hanson | Family Medicine | 520 W Indian Ave, Brewster, WA 98812 | 2006-03-20 |
| 1811956717 | Christopher J Casey | Physician Assistant | 520 W Indian Ave, Brewster, WA 98812 | 2006-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689032542 | Edith A Mcclosky | Massage Therapist | 718 West Main Avenue, Brewster, WA 98812 | 2016-02-08 |
| 1912327321 | Advantage Durable Medical Equipment, Inc | Durable Medical Equipment & Medical Supplies | 537 Main Ave, Brewster, WA 98812 | 2014-04-24 |
| 1639441165 | Central Washington Sleep Diagnostic Center, Pllc | Clinic/Center | 520 W Indian Avenue, Brewster, WA 98812 | 2012-01-30 |
| 1194019612 | Mitzi Gutierrez | Student in an Organized Health Care Education/Training Program | 343 E. Main Ave., Brewster, WA 98812 | 2011-06-01 |
| 1982938924 | Jason R Tucker | Dentist | 101 North 6th Street, Brewster, WA 98812 | 2009-09-23 |
| 1649409186 | Family Health Centers | Clinic/Center | 101 North Sixth Street, Brewster, WA 98812 | 2009-07-06 |
| 1972769446 | Bethany Lynn | Family Medicine | 418 W Main Street, Brewster, WA 98812 | 2008-08-04 |
| 1629237482 | Family Health Centers | Clinic/Center | 525 W Jay, Brewster, WA 98812 | 2008-06-06 |
| 1316138720 | L. Keith Hanson Pllc | Clinic/Center | 520 W. Indian Avenue, Brewster, WA 98812 | 2007-08-09 |
| 1639375124 | Robert Thomas Lamberton | Orthopaedic Surgery | 520 West Indian Avenue, Brewster, WA 98812 | 2007-06-22 |
| Find all providers in zip 98812 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972769446 | Bethany Lynn | Family Medicine | 418 W Main Street, Brewster, WA 98812 | 2008-08-04 |
| 1760683924 | James G Wallace Jr. | Family Medicine | 525 Jay Ave, Brewster, WA 98812-3403 | 2007-05-29 |
| 1295769446 | Anne Dubosky | Family Medicine | 418 W. Main St., Brewster, WA 98812 | 2006-07-11 |
| 1821022492 | Tamara Ellen Merritt | Family Medicine | 525 West Jay, Brewster, WA 98812-9701 | 2006-07-10 |
| 1821053208 | Main Street Health Associates, P.s. | Family Medicine | 418 West Main Avenue, Brewster, WA 98812 | 2006-04-19 |
| 1821076688 | Theodor Thomas Herwig | Family Medicine | 1 Independence Way, Brewster, MA 02631 | 2006-01-03 |
| 1447242235 | William A Rhodes | Family Medicine | 20 Granite State Ct, Brewster, MA 02631-2127 | 2005-08-17 |
| 1811341522 | Jessica Ann Wilson | Family Medicine | 155 Main St, Brewster, NY 10509-1521 | 2016-04-19 |
| 1689061517 | Erin Cooley | Family Medicine | 525 Jay Ave, Brewster, WA 98812-3403 | 2015-04-17 |
| 1811259195 | Wenatchee Valley Hospital | Family Medicine | 418 W. Main St., Brewster, WA 98812 | 2012-06-12 |
| Find all providers in BREWSTER | ||||
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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.