Mary Lane (NPI# 1437596301, PAC ID# 6305089731) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1437596301 |
| PAC ID by PECOS | 6305089731 |
| Professional Enrollment ID | I20130903000795 |
| Full Name | Mary Lane |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES WASHINGTON |
| Address |
4525 3rd Ave Se Suite 200 Lacey WA 98503-1010 |
| Phone Number | 3607543934 |
| Gender | F |
| Medical School | UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE |
| Graduation Year | 2012 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 6709782600 |
| Number of Group Practice Members | 315 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 500019 | PROVIDENCE CENTRALIA HOSPITAL |
| 500024 | PROVIDENCE ST PETER HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 954 Anderson Dr, Aberdeen, WA 98520-1001 | 3605336906 | PROVIDENCE HEALTH AND SERVICES WASHINGTON |
| 2015 Cooks Hill Rd, Centralia, WA 98531-9074 | 3603308939 | PROVIDENCE HEALTH AND SERVICES WASHINGTON |
| 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 | 3607543934 | PROVIDENCE HEALTH AND SERVICES WASHINGTON |
| 525 Lilly Rd Ne, Olympia, WA 98506-5101 | 3607937230 | PROVIDENCE HEALTH AND SERVICES WASHINGTON |
| 525 Lilly Rd Ne, Suite 250, Olympia, WA 98506-5101 | 3604866777 | PROVIDENCE HEALTH AND SERVICES WASHINGTON |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES WASHINGTON |
| Physicians | 1132 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarah Kinnard | Nurse Practitioner | Providence Health and Services Washington | 2555 Marvin Rd Ne, Lacey, WA 98516-3138 |
| Alexander Lee Telis | Orthopedic Surgery | Providence Health and Services Washington | 820 S Mcclellan St, Suite 300, Spokane, WA 99204-2450 |
| Jodi Ann Fischer | Nurse Practitioner | Providence Health and Services Washington | 1450 Northwest Ln Se, Suite A, Lacey, WA 98503-6908 |
| Katherine Elizabeth Reynolds | Nurse Practitioner | Providence Health and Services Washington | 1212 N Pines Rd, Spokane Valley, WA 99206-4939 |
| Eugene Daniel Villacian | Nurse Practitioner | Providence Health and Services Washington | 3333 Ensign Rd Ne, Olympia, WA 98506-5012 |
| Shira Y Albert | Nurse Practitioner | Providence Health and Services Washington | 12312 E Sprague Ave, Spokane Valley, WA 99216-0720 |
| Lisa Tisch | Nurse Practitioner | Providence Health and Services Washington | 551 E Hawthorne Rd, Spokane, WA 99218-1417 |
| Natalie S Angus | Family Medicine | Providence Health and Services Washington | 931 S Market Blvd, Chehalis, WA 98532-3423 |
| Tabatha Schellenger | Nurse Practitioner | Providence Health and Services Washington | 3760 Piper St, Suite 1108, Anchorage, AK 99508-4683 |
| Callie Rose Adams | Nurse Practitioner | Providence Health and Services Washington | 212 E Central Ave, Suite 240, Spokane, WA 99208-6597 |
| Street Address |
4525 3RD AVE SE SUITE 200 |
| City | LACEY |
| State | WA |
| Zip | 98503-1010 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Monique Cherri Semien | Hematology/oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Robyn Bell Vera | Radiation Oncology | Radiantcare Physicians Pllc | 4525 3rd Ave Se, Suite 100, Lacey, WA 98503-1010 |
| Justin William Suszko | Radiation Oncology | Radiantcare Physicians Pllc | 4525 3rd Ave Se, Suite 100, Lacey, WA 98503-1010 |
| Nora J Gant | Nurse Practitioner | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| John D O'boyle | Gynecological Oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Larisa G Raastad | Family Medicine | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Jocelyn Torres De Yao | Medical Oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Haleigh A Werner | Radiation Oncology | Radiantcare Physicians Pllc | 4525 3rd Ave Se, Suite 100, Lacey, WA 98503-1010 |
| Gregory W Allen | Radiation Oncology | Radiantcare Physicians Pllc | 4525 3rd Ave Se, Suite 100, Lacey, WA 98503-1010 |
| James F Raymond | Radiation Oncology | Radiantcare Physicians Pllc | 4525 3rd Ave Se, Suite 100, Lacey, WA 98503-1010 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Xingwei D Sui | Medical Oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Paul A Robertson | Hematology/oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Barbara Lazio | Neurology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Bojia Li | Hematology/oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Arthur Molina Iii | Medical Oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Daniel M Byrd | Hematology/oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Fen Jiang | Hematology/oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Brady Garland Miller | Medical Oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Hui Wang | Medical Oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| James J Lechner | Hematology/oncology | Providence Health and Services Washington | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 |
| Find all physicians in zip 98503 | |||
| City | LACEY |
| Zip Code | 98503 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LACEY + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Mary Lane.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.