Internal Medicine Consultants NW PS
Organization Active NPI Internal Medicine Physician · La Conner, WA
NPI 1497022370 · NPPES record last updated Dec 12, 2011
Key facts
- NPI
- 1497022370
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- INTERNAL MEDICINE CONSULTANTS NW PS
- Practice address
- 456 Klickitat Dr
La Conner, WA 98257-9517 - Phone
- (360) 466-9223
- NPI assigned
- Nov 21, 2011
- Organization subpart
- No
Authorized official
- Name
- Nancy Llewellyn, MD
- Title
- Owner
- Phone
- (360) 466-9223
Practitioners 7
-
Jennifer Eichhorn, ARNP, FNP-BC
-
Jennifer S. Gruenwald, ARNP
-
Sherry Love-Wenger, ARNP
-
Diana Bartlett, MSN
-
Dawn Darroch, ARNP
-
Nancy Hoover Llewellyn, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120202000483 | WA | Part B Supplier - Clinic/Group Practice | 1355508359 |
Receives reassigned benefits from 7 practitioners Practice locations: Mount Vernon, WA; Oak Harbor, WA; Anacortes, WA |
National Provider Directory
Locations
3502 K Ave
Anacortes, WA 98221
Phone (360) 419-6317
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
456 Klickitat Dr
La Conner, WA 98257-9517
Mailing address
PO Box 190
La Conner, WA 98257-0190
Other providers in La Conner, WA
- Patricia J Harlan
- Marianne Haworth
- Teylor Hendricks
- Rachael R Hogan
- Tamara M Holmes
- Gary Clayton Isham
- Justin Iwasaki
- Sabrina James
- Lauren B Jaye
- Alicia Jenkins
All providers in La Conner, WA · Internal Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.