CARIBOU TRAIL PROFESSIONAL MEDICAL GROUP (NPI# 1316123581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316123581 |
| Entity Type | Organization |
| Organization Name | CARIBOU TRAIL PROFESSIONAL MEDICAL GROUP |
| Practice Address |
520 W Indian Ave Brewster WA 98812-0220 |
| Mailing Address |
Po Box 220 520 W Indian Ave Brewster WA 98812-0220 |
| Practice Telephone | 5098261760 |
| Practice Fax Number | 5098269927 |
| Mailing Telephone | 5098261760 |
| Mailing Fax Number | 5098269927 |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2014-11-10 |
| Authorized Official Name | MR. MICHAEL D. BILLING (ADMINISTRATOR) |
| Authorized Official Telephone | 5098261760 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | OP00000831 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
520 W INDIAN AVE |
| City | BREWSTER |
| State | WA |
| Zip Code | 98812-0220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588623581 | L Keith Hanson Pllc | Clinic/Center | 520 W Indian Ave, Brewster, WA 98812 | 2006-03-20 |
| 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 |
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639375124 | Robert Thomas Lamberton | Orthopaedic Surgery | 520 West Indian Avenue, Brewster, WA 98812 | 2007-06-22 |
| 1043293160 | Pierre Andre Bruneau | Orthopaedic Surgery | 182 Rte 312, Brewster, NY 10509-2238 | 2005-11-22 |
| 1437318631 | Gabriel Dean Brown | Orthopaedic Surgery | 185 Route 312, Brewster, NY 10509-2337 | 2008-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902418189 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 2727 Hollycroft St Ste 410, Gig Harbor, WA 98335-1369 | 2020-08-19 |
| 1962968628 | Zachary Erin Schwartz | Orthopaedic Surgery | 9040 Fitzsimmons Drive- Orthopaedic Surgery, Joint Base Lewis Mcchord, WA 98431-1000 | 2019-02-18 |
| 1184106262 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 18100 Ne Union Hill Rd Ste 330, Redmond, WA 98052-3330 | 2018-09-05 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1184137770 | Walter Franklin Krengel Jr. | Orthopaedic Surgery | 2000 1st Ave Suite 2201, Seattle, WA 98122 | 2017-11-06 |
| 1821443383 | Chelan County Public Hospital District No 2 | Orthopaedic Surgery | 505 B State, Route 20, Winthrop, WA 98862 | 2016-05-03 |
| 1609254747 | William M Fallon | Orthopaedic Surgery | 3990 Saltspring Dr, Ferndale, WA 98248-9598 | 2015-05-08 |
| 1528470861 | Richard Dean Thorson | Orthopaedic Surgery | 719 S. Laurel St, Olympic Chiropractic, Port Angels, WA 98362 | 2014-05-21 |
| 1740600840 | Peters T. Otlans | Orthopaedic Surgery | 16259 Sylvester Rd Sw Ste 501, Burien, WA 98166-3059 | 2014-04-16 |
| 1912324559 | Floyd Sekeramayi | Orthopaedic Surgery | 630 N Fairview Dr, Tacoma, WA 98406-1015 | 2014-03-20 |
| 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.