COUNTRY DOCTOR COMMUNITY HEALTH CENTERS (NPI# 1639390982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639390982 |
| Entity Type | Organization |
| Organization Name | COUNTRY DOCTOR COMMUNITY HEALTH CENTERS |
| Other Organization Name | COUNTRY DOCTOR COMMUNITY CLINIC PHARMACY |
| Practice Address |
500 19th Ave E Seattle WA 98112-4007 |
| Practice Telephone | 2062991600 |
| Practice Fax Number | 2062991608 |
| Mailing Telephone | 2062991942 |
| Mailing Fax Number | 2062991920 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2016-09-28 |
| Authorized Official Name | SHONNIE NOMA (QUALITY IMPROVEMENT MANAGER) |
| Authorized Official Telephone | 2062991984 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
CF00004729 | WA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | PHARMACY | 6013965 | 01 |
| Other Name | Type Code |
|---|---|
| Country Doctor Community Clinic Pharmacy | Doing Business As Name - Organization |
| Street Address |
500 19TH AVE E |
| City | SEATTLE |
| State | WA |
| Zip Code | 98112-4007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629055801 | Cameron Clark Winter | Physician Assistant | 500 19th Ave E, Seattle, WA 98112-4007 | 2005-12-28 |
| 1033717301 | Megan Strader | Social Worker | 500 19th Ave E, Seattle, WA 98112-4072 | 2020-10-09 |
| 1922605542 | Catharine Alexandra Beveridge | Social Worker | 500 19th Ave E, Seattle, WA 98112-4072 | 2020-10-06 |
| 1538798368 | Casey Mccoy | Dietitian, Registered | 500 19th Ave E, Seattle, WA 98112-4072 | 2020-04-03 |
| 1568912830 | Glenn W Leever | Counselor | 500 19th Ave E, Seattle, WA 98112-4007 | 2016-10-10 |
| 1033669312 | Ivan V Sanchez | Counselor | 500 19th Ave E, Seattle, WA 98112-4007 | 2016-10-10 |
| 1831645993 | Bessie Chi | Pharmacist | 500 19th Ave E, Seattle, WA 98112-4007 | 2016-08-29 |
| 1174865521 | Emily Liebeskind | Registered Nurse | 500 19th Ave E, Seattle, WA 98112-4007 | 2013-03-25 |
| 1427302389 | Richard N Prasad | Case Manager/Care Coordinator | 500 19th Ave E, Seattle, WA 98112-4007 | 2012-10-30 |
| 1326392283 | Gerald M Knight | Case Manager/Care Coordinator | 500 19th Ave E, Seattle, WA 98112-4007 | 2012-10-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891254991 | Justin Jeng-young Fu | Student in an Organized Health Care Education/Training Program | 125 16 Th Ave E, Csb 545, Seattle, WA 98112 | 2019-03-18 |
| 1275015604 | Eyewear Gallery LLC | Optometrist | 3121 E. Madison St Ste 102, Seattle, WA 98112 | 2018-09-01 |
| 1336637081 | Oh Plastic and Reconstructive Surgery LLC | Plastic Surgery | 602 27th Ave E, Seattle, WA 98112 | 2018-04-27 |
| 1992228191 | John Joseph Folta | Chiropractor | 3121 E Madison St Ste 103a, Seattle, WA 98112 | 2017-07-19 |
| 1083161061 | Sheick Toure | Counselor | 122 16 Ave E, Seattle, WA 98112 | 2016-09-07 |
| 1457721805 | Jessica Donovan | Audiologist | 201 16th Ave E # Cmb, Seattle, WA 98112 | 2015-09-29 |
| 1952777427 | Ronald Berenson | Physiological Laboratory | 2032 41st Avenue, Seattle, WA 98112 | 2015-08-19 |
| 1225419005 | Adrienne Foley | Counselor | 1833 40th Ave. E., Seattle, WA 98112 | 2015-06-17 |
| 1952721771 | Ling Guo | Internal Medicine | Kaiser Permanente Central Hospital Building, 126 16th Ave E, Seattle, WA 98112 | 2014-04-19 |
| 1134548068 | Anne Gayman | Family Medicine | 125 16th Avenue East, Csb-540, Group Health Family Medicine Residency, Seattle, WA 98112 | 2014-04-08 |
| Find all providers in zip 98112 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023678240 | Washington Institute for Coagulation | Pharmacy | 921 Terry Ave Ste A, Seattle, WA 98104-1239 | 2019-06-19 |
| 1982025128 | Seattle Cancer Care Alliance | Pharmacy | 1560 N 115th St Ste G-16a, Seattle, WA 98133-8414 | 2013-12-13 |
| 1235263245 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1420 5th Ave., Suite 375, Seattle, WA 98101 | 2007-03-15 |
| 1639237142 | Sea Mar Community Health Center | Pharmacy | 8800 14th Ave S, Seattle, WA 98108-4864 | 2006-12-05 |
| 1235777616 | Harborview Medical Center | Pharmacy | 206 3rd Ave S, Seattle, WA 98104-2697 | 2019-12-16 |
| 1154712636 | Harborview Medical Center | Pharmacy | 325 9th Ave, 1st West Clinic, Seattle, WA 98104-2420 | 2015-02-05 |
| 1902027253 | Country Doctor Community Clinic | Pharmacy | 2101 E Yesler Way, Suite 150, Seattle, WA 98122-5959 | 2007-05-02 |
| 1629102470 | Kaiser Foundation Health Plan of Washington | Pharmacy | 201 16th Ave E, Seattle, WA 98112-5226 | 2007-03-15 |
| 1376677120 | Kaiser Foundation Health Plan of Washington | Pharmacy | 125 16th Ave E, Seattle, WA 98112-5211 | 2007-03-15 |
| 1508990201 | Kaiser Foundation Health Plan of Washington | Pharmacy | 5316 Rainier Ave S, Seattle, WA 98118-2398 | 2007-03-15 |
| Find all providers in SEATTLE | ||||
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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.