COASTAL INTERNAL MEDICINE, PLLC (NPI# 1740528884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740528884 |
| Entity Type | Organization |
| Organization Name | COASTAL INTERNAL MEDICINE, PLLC |
| Practice Address |
1921 Sumner Ave Aberdeen WA 98520-3606 |
| Mailing Address |
Po Box 87 Aberdeen WA 98520-0022 |
| Practice Telephone | 3605380135 |
| Practice Fax Number | 3605333475 |
| Mailing Telephone | 3605380135 |
| Mailing Fax Number | 3605333475 |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-01-24 |
| Authorized Official Name | MICHELLE PELT (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 3605380135 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA60328816 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265636401 | Coastal Internal Medicine, Pllc | Internal Medicine | 1921 Sumner Avenue, Aberdeen, WA 98520-2657 | 2007-06-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | COASTAL INTERNAL MEDICINE, PLLC | 1921 Sumner Ave, Aberdeen, WA 98520-3606 |
| Street Address |
1921 SUMNER AVE |
| City | ABERDEEN |
| State | WA |
| Zip Code | 98520-3606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568460814 | Anne M Wong May | Internal Medicine | 1921 Sumner Ave, Aberdeen, WA 98520-1001 | 2005-07-11 |
| 1396040770 | Elissa Freudenberg | Physician Assistant | 1921 Sumner Ave, Aberdeen, WA 98520-3606 | 2011-01-17 |
| 1669603106 | Anne Marie Wong, Md, Ps | Internal Medicine | 1921 Sumner Ave, Aberdeen, WA 98520-3606 | 2009-07-31 |
| 1013148550 | Timothy H. Troeh, Md, Ps | Internal Medicine | 1921 Sumner Ave, Aberdeen, WA 98520-3606 | 2009-07-31 |
| 1225239916 | Nicholas Hallak | Obstetrics & Gynecology | 1921 Sumner Ave, Aberdeen, WA 98520-3606 | 2007-05-30 |
| 1861609778 | Laura Arvilla Hallak | Family Medicine | 1921 Sumner Ave, Aberdeen, WA 98520-3606 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740755354 | Wchs, Inc. | Clinic/Center | 516 East 1st Street, Aberdeen, WA 98520 | 2018-10-10 |
| 1518454180 | Katie Cutshaw | Counselor | 1700 Cherry Street, Suite C, Aberdeen, WA 98520 | 2018-04-18 |
| 1629587738 | Robert Williams | Counselor | Catholic Community Services, 403 West State Street, Suite 206, Aberdeen, WA 98520 | 2017-09-21 |
| 1174032296 | Amy D Tyler | Peer Specialist | 403 W State Street, Ste 206, Aberdeen, WA 98520 | 2017-09-20 |
| 1073032819 | Amanda Leona Franklin | Counselor | 2700 Simpson Ave, Suite 101, Aberdeen, WA 98520 | 2017-09-13 |
| 1184141152 | Chrystal Lynn Beckley | Counselor | 2700 Simpson Avenue Suite 101, Aberdeen, WA 98520 | 2017-08-29 |
| 1285158923 | Josh Butler | Technician/Technologist | 1718 Sumner Ave, Aberdeen, WA 98520 | 2017-08-02 |
| 1386165553 | Melvin Taylor | Counselor | 311 South I Street, Aberdeen, WA 98520 | 2017-06-28 |
| 1164870267 | Kelly Knittle | Counselor | 4820 She-nah-num Dr. Se, Olympia, WA 98520 | 2016-05-31 |
| 1437570249 | Aberdeen Therapy Works | Occupational Therapist | 100 S. I Street, Suite 205, Aberdeen, WA 98520 | 2013-12-20 |
| Find all providers in zip 98520 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962043455 | Amanda Jennifer Lloyd | Physician Assistant | 147 Andover Ln, Aberdeen, NJ 07747-1230 | 2019-10-04 |
| 1730109547 | Percy E Golson | Physician Assistant | 815 First Avenue Se, Aberdeen, SD 57401 | 2006-07-21 |
| 1528031549 | Sean Christopher Kenny | Physician Assistant | 2301 8th Ave Ne Ste 225, Aberdeen, SD 57401-3253 | 2006-02-09 |
| 1730161399 | Debra S Mckay | Physician Assistant | 306 N Main, Aberdeen, ID 83210 | 2005-11-18 |
| 1619959236 | Wayne L Washenberger | Physician Assistant | 701 8th Ave Nw Ste A, Aberdeen, SD 57401-1865 | 2005-11-18 |
| 1164980108 | Christine Theresa De Carlo | Physician Assistant | 915 Anderson Dr, Aberdeen, WA 98520 | 2019-03-08 |
| 1275000994 | Rebecca Leilani Olbrys | Physician Assistant | 915 Anderson Dr, Aberdeen, WA 98520-1006 | 2018-10-31 |
| 1427537448 | Breanne Murray | Physician Assistant | 1211 Skyview Dr, Aberdeen, WA 98520-1099 | 2018-08-09 |
| 1386136158 | Katherine Fritz | Physician Assistant | 915 Anderson Dr, Aberdeen, WA 98520 | 2018-06-06 |
| 1659883627 | Sarah Elizabeth Hudson | Physician Assistant | 915 Anderson Dr, Aberdeen, WA 98520 | 2017-10-31 |
| Find all providers in ABERDEEN | ||||
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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.