Elizabeth Bagnulo Dacey, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

MD60843598 Issued in WA

Practice address

1225 Highland Avenue
Clarkston, WA 99403

Phone

(509) 758-4652

NPI assigned

Apr 12, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cascade Pathology Services, Corp

  • Anatomic Pathology & Clinical Pathology Physician
  • Vancouver, WA
  • NPI 1568618239

  Anatomic Pathology & Clinical Pathology, WA

  Medicare reassignment Care Compare group NPD
• Cascade Pathology Services, Corp

  • Anatomic Pathology & Clinical Pathology Physician
  • Portland, OR
  • NPI 1154465656

  Anatomic Pathology & Clinical Pathology, OR

  Medicare reassignment Care Compare group NPD
• Pacific Pathology Associates, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Salem, OR
  • NPI 1205997889

  Anatomic Pathology & Clinical Pathology, OR

  Medicare reassignment Care Compare group NPD
• Austin Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
  • NPI 1538172028

  Anatomic Pathology & Clinical Pathology

  NPD
• Austin Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
  • NPI 1669414330

  Anatomic Pathology & Clinical Pathology

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Legacy Salmon Creek Hospital

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784

  Hospital

  Care Compare affiliation
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003367491

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1295756898

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • Clinic/Center
  • Portland, OR
  • NPI 1679597108

  Hospital

  Care Compare affiliation
• Legacy Good Samaritan Hospital and Medical Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1780608216

  Hospital

  Care Compare affiliation
• Legacy Meridian Park Hospital

  • General Acute Care Hospital
  • Tualatin, OR
  • NPI 1184647620

  Hospital

  Care Compare affiliation
• Legacy Mount Hood Medical Center

  • General Acute Care Hospital
  • Gresham, OR
  • NPI 1255354700

  Hospital

  Care Compare affiliation

Specialty

Pathology

Education

Eastern Virginia Medical School, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cascade Pathology Services Corp 15 clinicians

Pacific Pathology Associates Inc 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089
• Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
• Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150
• Legacy Mount Hood Medical Center Hospital, Gresham, OR, CCN 380025
• Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 26)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1265799407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 COUNTRY CLUB DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835019678",
            "telephone_number": "208-816-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 HIGHLAND AVENUE",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "99403",
            "telephone_number": "509-758-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACEY",
        "first_name": "ELIZABETH",
        "middle_name": "BAGNULO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "ID",
            "license": "M-14192",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD60843598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Shannon Courtney
• Robert W Crothers, PHARMD
• Nola Cullum
• Bruce L Daugherty
• Dee Davison, M. ED
• Erick Timothy Dawson, BS
• Dean Hattan OD
• Charice Deguzman

• All providers in Clarkston, WA
• Anatomic Pathology & Clinical Pathology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.