BEAR CREEK PEDIATRICS (NPI# 1518470137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518470137 |
| Entity Type | Organization |
| Organization Name | BEAR CREEK PEDIATRICS |
| Practice Address |
105 W 8th Ave Ste 7035 Spokane WA 99204-2313 |
| Practice Telephone | 5098381188 |
| Mailing Telephone | 5098381188 |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2017-11-06 |
| Authorized Official Name | KAREN MCMAHAN (OFFICE MGR) |
| Authorized Official Telephone | 5098381188 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP30007917 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1048446 | 05 | |
| WA | 2026240 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | BEAR CREEK PEDIATRICS, PLLC | 1410 N Mullan Rd Ste 200, Spokane Vly, WA 99206-4046 |
| Street Address |
105 W 8TH AVE STE 7035 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760579866 | Kimberly D Resleff | Nurse Practitioner | 315 W 9th Ave Ste 200, Spokane, WA 99204 | 2006-10-09 |
| 1134192107 | Debra Ann Freund | Nurse Practitioner | 1919 S Grand Blvd, Spokane, WA 99203-2347 | 2006-02-09 |
| 1750377180 | Robin Coutant Gregory | Nurse Practitioner | 319 W 8th Ave, Spokane, WA 99204-2505 | 2005-09-21 |
| 1215309638 | Kristie Stolgitis | Nurse Practitioner | 817 S Perry St Unit B, Spokane, WA 99202 | 2015-10-25 |
| 1518289982 | Todd C Koch | Nurse Practitioner | 101 W 8th Ave, Ste. 100 L-1, Spokane, WA 99204-2307 | 2010-02-25 |
| 1275752198 | Jennifer Lynn Edminster | Nurse Practitioner | 5901 N Lidgerwood St, Suite 217, Spokane, WA 99208-5095 | 2007-04-25 |
| 1417057241 | Gale Elizabeth Taylor | Nurse Practitioner | 1402 S Grand Blvd, Spokane, WA 99203-2247 | 2006-09-22 |
| 1851303465 | Kimberly Gayle Alexander | Nurse Practitioner | 212 E Central, Suite 440, Spokane, WA 99208 | 2006-08-12 |
| 1841216587 | Fiona Elizabeth Dennison | Nurse Practitioner | 400 E 5th Ave, Spokane, WA 99202-1334 | 2006-07-14 |
| 1306877196 | Betty Ann Hartley-keith | Nurse Practitioner | 1919 S Grand Blvd, Spokane, WA 99203-2347 | 2006-07-06 |
| Find all providers in SPOKANE | ||||
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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.