Eileen P Smith (NPI# 1558340554, PAC ID# 6709807787) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1558340554 |
| PAC ID by PECOS | 6709807787 |
| Professional Enrollment ID | I20051219000429 |
| Full Name | Eileen P Smith |
| Organization Legal Name | EASTERN WASHINGTON DERMATOLOGY PLLC |
| Address |
228 W Birch St Walla Walla WA 99362-2935 |
| Phone Number | 5095259404 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF UTAH SCHOOL OF MEDICINE |
| Graduation Year | 1990 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 2062434962 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 500002 | PROVIDENCE ST MARY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 228 W Birch St, Walla Walla, WA 99362-2935 | 5095259404 | EASTERN WASHINGTON DERMATOLOGY PLLC |
| Organization Legal Name | EASTERN WASHINGTON DERMATOLOGY PLLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew Gambone | Physician Assistant | Eastern Washington Dermatology Pllc | 228 W Birch St, Walla Walla, WA 99362-2935 |
| Marla Kae Nmi Stahlnecker | Nurse Practitioner | Eastern Washington Dermatology Pllc | 228 W Birch St, Walla Walla, WA 99362-2935 |
| Street Address |
228 W BIRCH ST |
| City | WALLA WALLA |
| State | WA |
| Zip | 99362-2935 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew Gambone | Physician Assistant | Eastern Washington Dermatology Pllc | 228 W Birch St, Walla Walla, WA 99362-2935 |
| Marla Kae Nmi Stahlnecker | Nurse Practitioner | Eastern Washington Dermatology Pllc | 228 W Birch St, Walla Walla, WA 99362-2935 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cynthia A Wallace | Clinical Social Worker | 19 E Birch, Suite 103, Walla Walla, WA 99362 | |
| Susan L Stough | Clinical Social Worker | 409 E Sumach St, Suite 6, Walla Walla, WA 99362-1202 | |
| Natasha Anne Rustad | Clinical Social Worker | 409 E Sumach St, Rustad Counseling LLC, Walla Walla, WA 99362-1202 | |
| Pavel S Blagov | Clinical Psychologist | 409 E Sumach St, Suite 3, Walla Walla, WA 99362-1202 | |
| Robert L Stough Jr. | Psychologist, Clinical | 409 E Sumach St, Walla Walla, WA 99362-1228 | |
| Chance Higginbotham | Chiropractic | 2200 Melrose St, 7a, Walla Walla, WA 99362-1579 | |
| Alayna M Brinton | Clinical Social Worker | 2330 Eastgate St, Suite 140, Walla Walla, WA 99362-1589 | |
| Sean Thomas Duffy | Family Medicine | Yakima Valley Farm Workers Clinic | 1120 W Rose St, Walla Walla, WA 99362-1662 |
| Bradley K Nielson | Optometry | 208 N 2nd Ave, Walla Walla, WA 99362-1806 | |
| Eric John Wiessner | Optometry | 614 E Alder St, Suite 1, Walla Walla, WA 99362-2073 | |
| Find all physicians in zip 99362 | |||
| City | WALLA WALLA |
| Zip Code | 99362 |
| Specialty | DERMATOLOGY |
| City + Specialty | WALLA WALLA + DERMATOLOGY |
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| 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.