PIONEER FAMILY MEDICINE, PLLC (NPI# 1063037034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063037034 |
| Entity Type | Organization |
| Organization Name | PIONEER FAMILY MEDICINE, PLLC |
| Practice Address |
20 E J St Ste 2b Deer Park WA 99006-8500 |
| Mailing Address |
Po Box 1988 Deer Park WA 99006-1988 |
| Practice Telephone | 5099992123 |
| Mailing Telephone | 5092768012 |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-07-14 |
| Authorized Official Name | LEAH G KOBES (PRESIDENT/MANAGER) |
| Authorized Official Telephone | 5092768012 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2061253 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PIONEER FAMILY MEDICINE, PLLC | 20 E J St Ste 2b, Deer Park, WA 99006-8500 |
| Street Address |
20 E J ST STE 2B |
| City | DEER PARK |
| State | WA |
| Zip Code | 99006-8500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417572892 | Deer Park Dental Pllc | Dentist | 118 E. Crawford St., Deer Park, WA 99006 | 2020-06-11 |
| 1124653464 | James Phelan | Optometrist | 14 N. Vernon Ave., Deer Park, WA 99006 | 2020-03-06 |
| 1336628841 | Shayla Michelle Simonson | Massage Therapist | West 114 South Avenue, Apt 4, Deer Park, WA 99006 | 2018-08-07 |
| 1710221494 | Lori Tetsuro Mcdonald | Hearing Instrument Specialist | 23 E Crawford St, Suite D, Deer Park, WA 99006 | 2012-11-19 |
| 1952675076 | Debra Kay Keller | Pharmacist | 412 S Main, Deer Park, WA 99006 | 2012-03-07 |
| 1457661027 | Martha Joan Haney | Massage Therapist | W 110 Crawford, Suite J, Deer Park, WA 99006 | 2010-10-18 |
| 1487818324 | Bi-mart Corporation | Durable Medical Equipment & Medical Supplies | 412 S. Main Avenue, Deer Park, WA 99006 | 2008-07-10 |
| 1912104498 | Melissa Ann Mccollough | Massage Therapist | 20 East J Street Suite B, Deer Park, WA 99006 | 2007-06-28 |
| 1336368182 | Community Health Association of Spokane | Clinic/Center | 401 S Main Street, Deer Park, WA 99006 | 2007-04-24 |
| 1215153739 | Bates and Miller, Pllc, Dds | Clinic/Center | 20 E J Street, Suite 2b, Deer Park, WA 99006 | 2007-04-17 |
| Find all providers in zip 99006 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073845574 | Charles W Allen Mdpa | Clinic/Center | 2810 Center St, Suite 101, Deer Park, TX 77536-4987 | 2010-02-08 |
| 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 |
| 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 |
| 1225536923 | Family Medical Care Clinic LLC | Clinic/Center | 3425 Ensign Rd Ne Ste 320, Olympia, WA 98506-5068 | 2018-01-28 |
| Find all providers with the same taxonomy | ||||
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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.