ECLIPSE MEDICAL GROUP, INC. (NPI# 1982074621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982074621 |
| Entity Type | Organization |
| Organization Name | ECLIPSE MEDICAL GROUP, INC. |
| Practice Address |
3240 14th Ave Nw Olympia WA 98502-8509 |
| Practice Telephone | 3607900767 |
| Mailing Telephone | 3607900767 |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2015-10-06 |
| Authorized Official Name | ROSS VOGELGESANG (PRESIDENT) |
| Authorized Official Telephone | 3602594069 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Street Address |
3240 14TH AVE NW |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98502-8509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184613903 | Mary S. Eklund | Nurse Practitioner | 3240 14th Ave Nw, Olympia, WA 98502-8509 | 2005-10-14 |
| 1467692418 | Nhu-hoang Nguyen | Dentist | 3240 14th Ave Nw, Olympia, WA 98502-8509 | 2009-03-04 |
| 1457551897 | Kenneth Linc Hancock | Dentist | 3240 14th Ave Nw, Olympia, WA 98502-8509 | 2007-07-24 |
| 1316094121 | Victor H. Nguyen Dds Ps | Dentist | 3240 14th Ave Nw, Olympia, WA 98502-8509 | 2007-01-04 |
| 1578632527 | Erin J Henderson | Nurse Practitioner | 3240 14th Ave Nw, Olympia, WA 98502-8509 | 2006-11-06 |
| 1003908534 | Monglien T Nguyen | Dentist | 3240 14th Ave Nw, Suite B, Olympia, WA 98502-8509 | 2006-09-29 |
| 1962516377 | Dianna L Kaiser | Nurse Practitioner | 3240 14th Ave Nw, Olympia, WA 98502-8509 | 2006-08-19 |
| 1518919505 | Ross Edward Vogelgesang | Anesthesiology | 3240 14th Ave Nw, Olympia, WA 98502-8509 | 2006-05-17 |
| 1275585283 | Vogelgesang, Pllc | Anesthesiology | 3240 14th Ave Nw, Olympia, WA 98502-8509 | 2006-05-17 |
| 1427014745 | Lawrence Hartford | Physician Assistant | 3240 14th Ave Nw, Olympia, WA 98502-8509 | 2006-04-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409172 | Fanny Cordero | Interpreter | 1415 4th Ave W, Olympia, WA 98502 | 2020-08-26 |
| 1235762832 | Accessible Living Physical Therapy | Clinic/Center | 3524 7th Ave Se, Olympia, WA 98502 | 2020-02-21 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 1851946388 | Katherine Ann Vitela | Registered Nurse | 4909 Green Wood Dr Sw, Olympia, WA 98502 | 2019-08-01 |
| 1538632658 | Carmen Rae Breding | Massage Therapist | 2627 Capital Mall Dr Se, Olympia, WA 98502 | 2019-01-11 |
| 1285129155 | Fook Yee Cheung | Genetic Counselor, MS | 2010 Caton Way Sw Ste 102, Olympia, WA 98502 | 2018-06-24 |
| 1942724158 | William Coburn | Specialist/Technologist | 703 Lilly Road Ne, Suite 104, Olympia, WA 98502 | 2017-07-29 |
| 1225567415 | Thierry Buckner | Counselor | 2400 Bristol Court Sw, Olympia, WA 98502 | 2017-06-09 |
| 1619406048 | Trenton Reid | Massage Therapist | 2103 Harrison Ave Nw #2642, Olympia, WA 98502 | 2017-06-08 |
| 1962807305 | Richa Mehta | Dentist | 1530 Black Lake Boulevard, Suite A103, Olympia, WA 98502 | 2014-10-28 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326525023 | Cellnetix Labs, LLC | Clinical Medical Laboratory | 413 Lilly Rd Ne # Ddh06, Olympia, WA 98506-5133 | 2018-07-25 |
| 1558875369 | Laboratory Corporation of America | Clinical Medical Laboratory | 3525 Ensign Rd Ne Ste C, Olympia, WA 98506-5065 | 2017-12-01 |
| 1053682864 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 315 Cooper Point Rd Nw, Ste 103, Olympia, WA 98502-4446 | 2012-01-25 |
| 1386920973 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 420 Lilly Road Ne, Suite 101, Olympia, WA 98506-5132 | 2011-10-26 |
| 1740445949 | Dynacare Northwest Inc. | Clinical Medical Laboratory | 3425 Ensign Rd Ne Ste 250c, Olympia, WA 98506-5425 | 2008-07-28 |
| 1952815763 | Laboratory Corporation of America | Clinical Medical Laboratory | 3425 Ensign Rd Ne Ste 250, Olympia, WA 98506-5063 | 2017-12-01 |
| 1972017788 | Laboratory Corporation of America | Clinical Medical Laboratory | 1620 Cooper Point Rd Sw, Olympia, WA 98502-5736 | 2017-12-01 |
| 1942684501 | Laboratory Corporation of America | Clinical Medical Laboratory | 1100 Eastside St Se, Olympia, WA 98501-7304 | 2015-07-14 |
| 1558741223 | Laboratory Corporation of America | Clinical Medical Laboratory | 404 Yauger Way Sw Ste 100, Olympia, WA 98502-8152 | 2015-06-08 |
| 1396165825 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 410 Black Hills Ln Sw, Ste B, Olympia, WA 98502-8155 | 2014-04-23 |
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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.