CHANEL PEDERSEN (NPI# 1154877645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154877645 |
| Entity Type | Individual |
| Full Name | CHANEL PEDERSEN |
| Practice Address |
690 Barnes Blvd Joint Base Lewis Mcchord WA 98438-1303 |
| Practice Telephone | 2539825603 |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | LP60474414 | WA | Nursing Service Providers |
| Street Address |
690 BARNES BLVD |
| City | JOINT BASE LEWIS MCCHORD |
| State | WA |
| Zip Code | 98438-1303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083600068 | Kathleen Greenhalgh | Nurse Practitioner | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2005-09-23 |
| 1982175113 | Miguel Antonio Rodriguez Jr. | Military Health Care Provider | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2018-12-16 |
| 1184135428 | Eric Logan Dorner | Case Manager/Care Coordinator | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2017-10-13 |
| 1952812349 | Jodie Mitchell | Case Manager/Care Coordinator | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2017-10-12 |
| 1093226458 | Jayce Moody | Dental Hygienist | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2017-10-12 |
| 1861916801 | Christopher D Lucio Strayer | Military Health Care Provider | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2017-08-01 |
| 1063864809 | Tom Thomas | Registered Nurse | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2016-07-05 |
| 1407228737 | Jamye Patrice Gore | Nurse Practitioner | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2015-10-26 |
| 1922488360 | Alexander Dominic Jobrack | Preventive Medicine | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1336 | 2015-06-01 |
| 1255677225 | Lois Fisher | Counselor | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2012-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457810483 | Roveds Kaarins | Nursing Care | Mcchord Air Force Base Clinic, 690 Barnes Blvd Jblm Lakewood Wa, Apo, AA 98438 | 2019-03-19 |
| 1326459843 | Dr Larsen Eye Care Inc | Optometrist | 504 A St Mcchord Main Exchange, Ft. Lewis Mcchord Afb, WA 98438 | 2014-05-19 |
| 1548580392 | Kevin Lok | Family Medicine | 600 Barnes Blvd., Mcchord Medical Clinic, Jblm, WA 98438 | 2010-06-03 |
| 1720205578 | Nathan Kane Fosmore | Registered Nurse | Us Dept of The Us Airforce, 690 Barnes Blvd, Mcchord Afb, WA 98438 | 2007-04-20 |
| 1225176951 | Ronald Richardson Morris | Family Medicine | 690 Barnes Road, Mcchord Medical Clinic Fam Med Clinic, Joint Base Lewis Mcchord, WA 98438 | 2007-02-02 |
| 1770527418 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | A Street Bldg 504, Mcchord Afb, WA 98438 | 2006-06-15 |
| 1982660692 | Shanti Jones | Registered Nurse | 62nd Med Group, 690 Barnes Ave, Mcchord Afb, WA 98438 | 2006-04-21 |
| 1578547436 | Cynthia Lee Fry-spray | Physician Assistant | 691 Barnes Blvd, Mcchord Afb, WA 98438 | 2005-12-05 |
| 1366432171 | Robert Dean Rock | Dentist | 527 Barnes Blvd, Mcchord Air Forse Base Dental Clinic, Mcchord, WA 98438 | 2005-10-24 |
| 1457344913 | Norman Harris | Dentist | 62mdos/sgod 690 Barnes Blvd., Mcchord Afb, WA 98438 | 2005-08-30 |
| Find all providers in zip 98438 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811203037 | Brian D Worley | Licensed Practical Nurse | Mamc 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1100 | 2010-08-25 |
| 1275195877 | Michael C Saenz | Licensed Practical Nurse | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2019-07-03 |
| 1144696865 | Stacie Ketcham | Licensed Practical Nurse | 9040 Reid St, Attn:mchj-clq-c, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-08-17 |
| 1457737314 | Cathy Crawford | Licensed Practical Nurse | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-08-03 |
| 1598071789 | Quantrell L Felder | Licensed Practical Nurse | 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1100 | 2010-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163424 | Joseph Mbote | Licensed Practical Nurse | 1017 W 17th St, Port Angeles, WA 98363-7435 | 2020-10-29 |
| 1942808332 | Christine S Kruger | Licensed Practical Nurse | 103 E Main St Ste 304, Walla Walla, WA 99362-1900 | 2020-10-16 |
| 1346857422 | Robert Gitonga | Licensed Practical Nurse | 3206 94th St S, Lakewood, WA 98499-3553 | 2020-09-23 |
| 1366058869 | Ruth Wakarima Martineau | Licensed Practical Nurse | 2100 S 336th St, Federal Way, WA 98003-8961 | 2020-09-20 |
| 1275143570 | Hiljay Homes Inc | Licensed Practical Nurse | 111 Nw 203rd St, Shoreline, WA 98177-2019 | 2020-08-03 |
| 1437767050 | Kimberley Damian | Licensed Practical Nurse | 1902 E Kessler Blvd, Longview, WA 98632-1844 | 2020-07-20 |
| 1649897505 | Erin Day | Licensed Practical Nurse | 12101 Daphne Ln Nw Apt B108, Silverdale, WA 98383-8680 | 2020-06-26 |
| 1003432782 | Jayde M Wright | Licensed Practical Nurse | 638 12th St, Washougal, WA 98671-1309 | 2020-06-18 |
| 1225652597 | Caesar Mburu | Licensed Practical Nurse | 4607 Sw 327th St, Federal Way, WA 98023-1901 | 2020-06-03 |
| 1922629427 | Helen Kigonya Babirye I | Licensed Practical Nurse | 9625 Croft St S, Tacoma, WA 98444-6533 | 2020-05-06 |
| Find all providers with the same taxonomy | ||||
| City | JOINT BASE LEWIS MCCHORD |
| Zip Code | 98438 |
Please comment or provide details below to improve the information on CHANEL PEDERSEN.
| 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.