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Regence BlueAdvantage HMOHMO PlanProvider DirectoryThis directory provides a list of Regence BlueAdvantage HMO’s network providers.This directory is for King, Pierce, and Snohomish Counties in the state of Washington.This directory is current as of March 13, 2014. Some network providers may have been added orremoved from our network after this directory was printed. We do not guarantee that eachprovider is still accepting new members. To get the most up-to-date information about RegenceBlueAdvantage HMO’s network providers in your area, you can visitwww.regence.com/medicare or call our Customer Service Department at 1 (855) 522-8896, from8:00 a.m. to 8:00 p.m., Monday through Friday (from October 1 through February 14, ourtelephone hours are 8:00 a.m. to 8:00 p.m., seven days a week). TTY users should call 711.Regence BlueShield is an HMO plan with a Medicare contract. Enrollment in RegenceBlueShield depends on contract renewal.This document is available electronically and may be available in alternate formats. Please callCustomer Service at the telephone number listed above for more information.Regence BlueShield serves select counties in the state of Washington and is an IndependentLicensee of the Blue Cross and Blue Shield Association.H1997 2014PROVDIR HMO V2 ACCEPTED
Section 1 – IntroductionThis directory provides a list of Regence BlueAdvantage HMO’s network providers. To getdetailed information about your health care coverage, please see your Evidence of Coverage.You will have to choose one of our network providers who are listed in this directory to be yourPrimary Care Provider (PCP). The term “PCP” will be used throughout this directory.Generally, you must get your health care coverage from your PCP. Your PCP is the providerthat will coordinate your medical care. You will find the PCPs in our network listed in the“Primary Care Providers” section of this directory. PCPs may include Family Practice, GeneralPractice, Geriatric, and Internal Medicine doctors, and Primary Care Nurse Practitioners andPhysician Assistants. Pediatricians may also be used as a PCP if appropriate to the age of themember.The “network providers” listed in this directory have agreed to provide you with your health carecoverage. You may go to any of our network providers listed in this directory; however, someservices may require a referral. If you have been going to one network provider, you are notrequired to continue going to that same provider. In some cases, you may get covered servicesfrom non-network providers. Your PCP will coordinate referrals for your healthcare with ournetwork providers. A referral is an approval from your PCP for you to see a specialist or otherprovider. In most cases, medical services obtained without a PCP referral will not be covered.Some services may require prior authorization from the plan. When necessary, your PCP willobtain prior authorization from the plan for these services.If your PCP determines there is a medical reason you must see an out-of-network provider, yourPCP must obtain prior authorization from the plan before services are rendered. If priorauthorization approval is not obtained from the plan, services will not be covered.If you receive plan-approved care from an out-of-network provider, have the provider bill theplan by following the instructions on the back of your ID card. If you receive a bill from an outof-network provider, submit the bill to the plan for processing. Addresses for claims submissionare listed in the Evidence of Coverage or on the back of your member ID card. You may alsocontact Customer Service for assistance. The phone number and hours for Customer Service arelisted on the front of this directory.When you travel outside the Regence BlueAdvantage HMO service area, the only servicescovered are medically necessary emergency or urgent care visits, and renal dialysis services.You must use plan providers except in emergency or urgent care situations or for out-of-arearenal dialysis. If you obtain routine care from out-of-network providers, neither Medicare norRegence BlueAdvantage HMO will be responsible for the costs.What is the service area for Regence BlueAdvantage HMO?The counties in our service area are listed below:King, Pierce, and Snohomish Counties in the state of Washington.1
How do you find Regence BlueAdvantage HMO providers in yourarea?To find a provider near you, identify the type of provider using the directory table of contents.Turn to the page listed and search for providers by state, then city. Unless otherwise indicated,all practices are accepting new patients.Directory Table of Contents Primary Care Providers – 1,536 total providersSorted by state, city, specialty, then name4 Specialists – 7,397 total providersSorted by state, city, specialty, then name86 Mental Health Providers – 541 total providersSorted by state, city, specialty, then name398 Hospitals – 12 total providersSorted by state, city, then name422 Skilled Nursing Facilities – 46 total providersSorted by state, city, then name423 Other Providers/Facilities – 390 total providersSorted by state, city, specialty then name426 Alphabetical Provider Index – Sorted by name446If you have questions about Regence BlueAdvantage HMO or require assistance in selecting aPCP, please call our Customer Service Department at 1 (855) 522-8896, from 8:00 a.m. to8:00 p.m., Monday through Friday (from October 1 through February 14, our telephone hours are8:00 a.m. to 8:00 p.m., seven days a week). TTY users should call 711. Or, visitwww.regence.com/medicare.2
Section 2 – List of Network Providers3
WASHINGTONAUBURNFAMILY PRACTICEPrimary Care ProvidersSorted by state, city, specialty, then nameCURTIS, ANNA TERESA DO735 12TH ST SEAUBURN, WA 98002AUBURN(253) 876-7997FAMILY PRACTICEProvider ID: 100000036655NPI: 1326067166BANGALORE KRISHNAIAH,DARBY, PHILLIP A PAPOORNIMA MD202 CROSS ST SE735 12TH ST SEAUBURN, WA 98002AUBURN, WA 98002(253) 876-8111(253) 876-7997Provider ID: 100001000341Provider ID: 100000644193NPI: 1023037868NPI: 1497948467Provider Speaks: HINDI,DE GUZMAN-ABAJERO,KANNADAMARICAR ONGOCO MD202 CROSS ST SEBOUMA, JESS WESTON MDAUBURN, WA 98002202 N DIVISION ST STE 301AUBURN, WA 98001(253) 372-7900Provider ID: 100000065917(253) 876-7997NPI: 1912923053Provider ID: 100000997696NPI: 1073538062DEALY, RICHARD J ARNP735 12TH ST SECHANG, VON V MDAUBURN, WA 98002735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000979256(253) 876-7997NPI: 1255765541Provider ID: 100000080256NPI: 1003844804DO, DANG H MD202 CROSS ST SECHE, JUNGHEE ARNPAUBURN, WA 98002202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000976477(253) 876-8111NPI: 1891953766Provider ID: 100000968337Provider Speaks: VIETNAMESENPI: 1144510884CHEN, HILTON ANTHONY MD ERICKSEN, SALLY M ARNP735 12TH ST SE202 CROSS ST SEAUBURN, WA 98002AUBURN, WA 98002(253) 876-7997(253) 876-8111Provider ID: 100000994476Provider ID: 100000054682NPI: 1528375284NPI: 1821017922ESTRADA, JOEL F MDCONSTANCE, PAULA ANN735 12TH ST SEARNPAUBURN, WA 98002202 CROSS ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000785954(253) 876-8111NPI: 1811040173Provider ID: 100000047378Provider Speaks: SPANISH,NPI: 1437175676TAGALOGWASHINGTONMarch 13, 20144WASHINGTONAUBURNFAMILY PRACTICEGOLAN, NEIL EDWIN MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000058474NPI: 1407969314Provider Speaks: SPANISHGREELY, MICHAEL JOSEPHMD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000038211NPI: 1164520615GUSLER, JAY KEVIN MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000053252NPI: 1831281401HARKINS, KARYN I MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000065039NPI: 1336231901HARMON, CHRISTINE LOUISEMD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001003744NPI: 1154417608HAWKINS, RICHARD SCOTTMD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100001003738NPI: 1912925207HERMAN, ERIC D MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001003339NPI: 1851483432
WASHINGTONAUBURNFAMILY PRACTICEWASHINGTON (cont'd)AUBURN (cont'd)FAMILY PRACTICE (cont'd)JOHNS, ALEXINNA C MD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000804350NPI: 1073731006JONES, LISA A ARNP202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000880011NPI: 1578808465JOSLIN-LESTER, LUANA AARNP34520 16TH AVE SAUBURN, WA 98003(253) 838-1500Provider ID: 100000855382NPI: 1104921964Provider Speaks: SPANISHKALLOCK, ERIN K MD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000359011NPI: 1053574335202 N DIVISION ST STE 400AUBURN, WA 98001(253) 833-7256Provider ID: 100001002384NPI: 1053574335735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000359011NPI: 1053574335Provider Speaks: SPANISHPrimary Care ProvidersSorted by state, city, specialty, then nameKEAYS, ASHLEY C DO202 N DIVISION ST STE 400AUBURN, WA 98001(253) 833-7256Provider ID: 100001002404NPI: 1346456696735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001002403NPI: 1346456696KONG, NATALIE K A MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000959716NPI: 1457678351KRILICH, CHAD B MD202 N DIVISION ST STE 400AUBURN, WA 98001(253) 833-7256Provider ID: 100001002910NPI: 1932115771KUCERA, CHARLES J MD202 N DIVISION ST STE 400AUBURN, WA 98001(253) 833-7256Provider ID: 100001003007NPI: 1811004351LEON, ENRIQUE CONRAD MD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000966276NPI: 1639187925Provider Speaks: SPANISHMACCIO, MARY ELLEN MD1 E MAIN ST STE 100AUBURN, WA 98002(253) 939-9654Provider ID: 100000743061NPI: 1275566879Provider Speaks: FRENCH5WASHINGTONAUBURNFAMILY PRACTICEMEKA, SRINIVASA R MD202 N DIVISION ST STE 400AUBURN, WA 98001(253) 833-7256Provider ID: 100001002969NPI: 1841395050735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000554228NPI: 1841395050Provider Speaks: HINDIMEYER, PAULA ANN MD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100001002140NPI: 1497762900NGUYEN, DANGTUONG V MD202 CROSS ST SEAUBURN, WA 98002(253) 459-7177Provider ID: 100000245271NPI: 1538295688735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000245271NPI: 1538295688NGUYEN, KHANH DINH MD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100001001808NPI: 1871509851Provider Speaks: VIETNAMESENGUYEN, VIET H ARNP202 N DIVISION ST STE 400AUBURN, WA 98001(253) 833-7256Provider ID: 100001001792NPI: 1386709384735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001001791NPI: 1386709384March 13, 2014
WASHINGTONAUBURNFAMILY PRACTICEWASHINGTON (cont'd)AUBURN (cont'd)FAMILY PRACTICE (cont'd)O'BRIEN, MARY K MD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100001001788NPI: 1952317927Provider Speaks: SPANISHOLSON, GINA M PAC735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001001783NPI: 1801802871PAINTER, CHAD L MD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100001001642NPI: 1538267729PANG, NANCY C MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000070560NPI: 1538173885PEARSON, KARIN E ARNP202 N DIVISION ST STE 400AUBURN, WA 98001(253) 833-7256Provider ID: 100001001576NPI: 1467752782PECK, DENNIS WAYNE MD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100001001571NPI: 1114942596March 13, 2014Primary Care ProvidersSorted by state, city, specialty, then nameREISENAUER, SARAH J ARNP735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001001343NPI: 1912257635RENELLA, CATHERINE DARNP202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100001001332NPI: 1710900139REYRAO, ROWENA LILY BEL PMD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000065277NPI: 1376566794ROBERTS, STEVEN G ARNP735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001001279NPI: 1972771186ROSS, HARRY EUGENE ARNP202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000959731NPI: 1235299181RUSSELL, PATRICIA JEAN MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001001182NPI: 1881617207SANDS, JARRET E DO202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100001001154NPI: 16199462176WASHINGTONAUBURNFAMILY PRACTICESARNER, ROBINMACLAUGHLIN MD202 CROSS ST SEAUBURN, WA 98002(253) 459-6065Provider ID: 100000056639NPI: 1952322539SCHOEN, DAVID A PAC202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100001001142NPI: 1457374902SHOW, MICHELLE R MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001001121NPI: 1184844946SIMPSON, REBECCA R MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001001112NPI: 1487677258SMATHERS, DOUG H MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001000830NPI: 1083670004STEVENSON, RAE L MD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000959741NPI: 1255593307STOROZHUK, TATYANA A PAC202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000953995NPI: 1396980215Provider Speaks: RUSSIAN,UKRAINIAN
WASHINGTONAUBURNFAMILY PRACTICEWASHINGTON (cont'd)AUBURN (cont'd)FAMILY PRACTICE (cont'd)SWANSON, ANA D MD202 N DIVISION ST STE 400AUBURN, WA 98001(253) 833-7256Provider ID: 100001000116NPI: 1245442946735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000702334NPI: 1245442946THOMPSON, DANIEL WAYNEMD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000062142NPI: 1962422824THOMPSON, ROSANNE J ARNP202 CROSS ST SEAUBURN, WA 98002(253) 459-6065Provider ID: 100000314828NPI: 1134145337TRAN, CAMHONG T ARNP121 N DIVISION STAUBURN, WA 98001(253) 735-0843Provider ID: 100000704310NPI: 1679524359Provider Speaks: VIETNAMESEWHITEMARSH, BRYAN D MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100001003931NPI: 1841230828Primary Care ProvidersSorted by state, city, specialty, then nameWITTMAN, CHERON L PA735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000758718NPI: 1427087378WOOD, PATRICIA SUSAN PAC202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000045736NPI: 1659396026INTERNAL MEDICINEARBUCK, MARINA MD202 N DIVISION ST STE 301AUBURN, WA 98001(253) 876-7997Provider ID: 100000742784NPI: 1992894851Provider Speaks: ITALIAN,RUSSIAN, UKRAINIANBIRSE, STEWART CRAIG MD202 N DIVISION ST STE 301AUBURN, WA 98001(253) 876-7997Provider ID: 100000035330NPI: 1144245168BOSAK, PETER MD202 N DIVISION ST STE 301AUBURN, WA 98001(253) 876-7997Provider ID: 100000104551NPI: 1811912892DAWOOD, AYAD J MD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000824832NPI: 17109461087WASHINGTONAUBURNINTERNAL MEDICINEDEVITA, JOCELYN VALLARTAMD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100000953746NPI: 1437176245Provider Speaks: SPANISHESTRADA, JOEL F MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000785954NPI: 1811040173Provider Speaks: SPANISH,TAGALOGGETTEL, NADINE KAY MD202 N DIVISION ST STE 301AUBURN, WA 98001(253) 876-7997Provider ID: 100000058473NPI: 1295848281GINSBERG, DANIEL CHAIMMD202 CROSS ST SEAUBURN, WA 98002(253) 876-8111Provider ID: 100001003065NPI: 1841303740Provider Speaks: FRENCH,JAPANESEHAMILL, LISA VALERIE MD735 12TH ST SEAUBURN, WA 98002(253) 876-7997Provider ID: 100000539669NPI: 1578655148March 13, 2014
WASHINGTONAUBURNINTERNAL MEDICINEPrimary Care ProvidersSorted by state, city, specialty, then nameWASHINGTON (cont'd)PEDIATRICSEVANS, TANJA D MDAUBURN (cont'd)202 N DIVISION ST STE 202INTERNAL MEDICINE (cont'd) AUBURN, WA 98001(253) 876-8088NAM, CHARLES CHAN MDProvider ID: 100000893812202 N DIVISION ST STE 400NPI: 1295777175AUBURN, WA 98001LECLAIR, ROBERT J MD(253) 833-7256202 CROSS ST SEProvider ID: 100001002129AUBURN, WA 98002NPI: 1588611313(253) 876-8111735 12TH ST SEProvider ID: 100001002425AUBURN, WA 98002NPI: 1740297522(253) 876-7997LINDALE, MEGAN D ARNPProvider ID: 100000785955202 N DIVISION ST STE 202NPI: 1588611313AUBURN, WA 98001Provider Speaks: KOREAN(253) 876-8088NGUYEN, KHOA VAN MDProvider ID: 100000737406202 CROSS ST SENPI: 1598868374AUBURN, WA 98002MYERS, RAYMOND R MD(253) 876-8111202 N DIVISION ST STE 202Provider ID: 100001001798AUBURN, WA 98001NPI: 1154337137(253) 876-8088PASTERNAK, KEITH CHARLESProvider ID: 100000737417MDNPI: 1821064866202 CROSS ST SEORIEL,BRUCE MDAUBURN, WA 98002202 N DIVISION ST STE 202(253) 876-8111AUBURN, WA 98001Provider ID: 100001001627(253) 876-8088NPI: 1477567725Provider ID: 100000737314SANTOS, NILO S MDNPI: 1043313158202 N DIVISION ST STE 301AUBURN, WA 98001BELLEVUE(253) 876-7997FAMILY PRACTICEProvider ID: 100000070088NPI: 1952345084DAMBERG, MARK L PACProvider Speaks: TAGALOG13231 SE 36TH ST STE 110BELLEVUE, WA 98006TURNER, JILL MD202 N DIVISION ST STE 301(206) 520-5000AUBURN, WA 98001Provider ID: 100000979214NPI: 1952606477(253) 876-7997Provider ID: 100000954006NPI: 1598847451March 13, 20148WASHINGTONBELLEVUEFAMILY PRACTICEGLYNN-THAMI, MAURA ELLENMD 13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000038031NPI: 1720163553Provider Speaks: FRENCH,SPANISHHEI, THOMAS KOU MD13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000269176NPI: 1194839837Provider Speaks: CHINESE,MANDARINKAO, DIANA J MD13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000687068NPI: 1548346711Provider Speaks: TAIWANESELINDOW, MICHAEL S MD13231 SE 36TH ST STE 110BELLEVUE, WA 98006(206) 520-5000Provider ID: 100000987010NPI: 1821226051MAJD, IMAN MD 13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000849473NPI: 1831237452Provider Speaks: FARSI,FRENCHMCCOLLUM, BRYNA D PAC13231 SE 36TH ST STE 110BELLEVUE, WA 98006(206) 520-1099Provider ID: 100000252315NPI: 1164503314Provider Speaks: SPANISH This provider is not acceptingnew patients at this time
WASHINGTONBELLEVUEFAMILY PRACTICEWASHINGTON (cont'd)BELLEVUE (cont'd)FAMILY PRACTICE (cont'd)MCFARLAND, NEIL A MD3100 NORTHUP WAYBELLEVUE, WA 98004(206) 520-5000Provider ID: 100001027619NPI: 1285790022Provider Speaks: SPANISHPELTO III, HENRY F MD13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000952942NPI: 1659514909PIEHL, JANET H MD13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000076306NPI: 1629153440PLATT, KELSEY R ARNP13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000596360NPI: 1023326071PLATZNER, ANNE MD 13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000061934NPI: 1538244355UMAPATHY, MENAKA MD13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000722077NPI: 1609027259Provider Speaks: TAMIL This provider is not acceptingnew patients at this timePrimary Care ProvidersSorted by state, city, specialty, then nameYUNG, PAMELA MEI MD 13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000054842NPI: 1386729119INTERNAL MEDICINECHOUDHURY, NEETILEKHAMD13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000075389NPI: 1962587766DY, EDWARD S MD 13231 SE 36TH ST STE 110BELLEVUE, WA 98006(425) 957-9000Provider ID: 100000277940NPI: 1790771947BONNEY LAKEFAMILY PRACTICECHAO, GRACE K PA 10004 204TH AVE EBONNEY LAKE, WA 98391(253) 848-5951Provider ID: 100000746907NPI: 1134496862GREGORY, GARRY L PAC 19820 STATE ROUTE 410 E STE101BONNEY LAKE, WA 98391Provider ID: 100000562432NPI: 1992859045JOSLIN-LESTER, LUANA AARNP21220 SR 410 EBONNEY LAKE, WA 98391(253) 447-4770Provider ID: 100000782856NPI: 1104921964Provider Speaks: SPANISH9WASHINGTONBONNEY LAKEFAMILY PRACTICEKEITH WOODS, ELLEN M PAC 10004 204TH AVE EBONNEY LAKE, WA 98391(253) 848-5951Provider ID: 100000894671NPI: 1518205210KOMAROW, JULIE ANN MD 10004 204TH AVE EBONNEY LAKE, WA 98391(253) 848-5951Provider ID: 100000255674NPI: 1295757862LEE, JOHNY K PAC 19820 STATE ROUTE 410 E STE101BONNEY LAKE, WA 98391(253) 863-6888Provider ID: 100000273400NPI: 1598868218MCDONALD, SUSANELIZABETH MD 19820 STATE ROUTE 410 E STE101BONNEY LAKE, WA 98391(253) 863-6888Provider ID: 100000059878NPI: 1740343995STOUT, SEAN S MD 19820 STATE ROUTE 410 E STE101BONNEY LAKE, WA 98391(253) 863-6888Provider ID: 100000075739NPI: 1316925498Provider Speaks: JAPANESESWISHER, BRANDON A PAC 19820 STATE ROUTE 410 E STE101BONNEY LAKE, WA 98391(253) 863-6888Provider ID: 100000117771NPI: 1013949452March 13, 2014
WASHINGTONBONNEY LAKEFAMILY PRACTICEPrimary Care ProvidersSorted by state, city, specialty, then nameBRINCKERHOFF, MELANIE AARNP1909 214TH ST SE STE 110BONNEY LAKE (cont'd)BOTHELL, WA 98021FAMILY PRACTICE (cont'd)(425) 488-4988Provider ID: 100000598716TRAN, CAMHONG T ARNPNPI: 136659233921220 SR 410 EProvider Speaks: SPANISHBONNEY LAKE, WA 98391CHACKO, LEENA MD(253) 447-47701909 214TH ST SE STE 110Provider ID: 100000523243BOTHELL, WA 98021NPI: 1679524359(425) 488-4988Provider Speaks: VIETNAMESEProvider ID: 100000115048WITTMAN, CHERON L PANPI: 163920613910004 204TH AVE E STE 2200Provider Speaks: HINDIBONNEY LAKE, WA 98391CHAN, WILSON MD(253) 447-33001909 214TH ST SE STE 110Provider ID: 100000758713BOTHELL, WA 98021NPI: 1427087378(425) 488-4988INTERNAL MEDICINEProvider ID: 100000644980NPI: 1538281530GARA, NEDAL MDProvider Speaks: CANTONESE,10004 204TH AVE E STE 2300CHINESE, MANDARINBONNEY LAKE, WA 98391CHIBAMBO, HEATHER D MD(253) 447-33371909214TH ST SE STE 110Provider ID: 100000855381BOTHELL,WA 98021NPI: 1205076916(425) 488-4988BOTHELLProvider ID: 100000900420NPI: 1588814669FAMILY PRACTICECOOLEY, JANINE R MDANDERSON, DENNIS ROLLAND 1909 214TH ST SE STE 110DOBOTHELL, WA 980211909 214TH ST SE STE 110(425) 488-4988BOTHELL, WA 98021Provider ID: 100000802008(425) 488-4988NPI: 1013905009Provider ID: 100000974568CORCORAN, HELEN G PACNPI: 13866896281909 214TH ST SE STE 110BATES, RACHEL A ARNPBOTHELL, WA 980211909 214TH ST SE STE 110(425) 488-4988BOTHELL, WA 98021Provider ID: 100000973269(425) 488-4988NPI: 1073701454Provider ID: 100000709485NPI: 1154619054WASHINGTON (cont'd)March 13, 201410WASHINGTONBOTHELLFAMILY PRACTICECUFLEY, TRAVIS JO G ARNP1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000948898NPI: 1295968360Provider Speaks: SPANISHCURTIS, MILTON L MD 1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000036658NPI: 1689656597DAY, TRAVIS A ARNP1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100001019147NPI: 1912333451DY, GRACE T MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000876588NPI: 1295792109Provider Speaks: CHINESE,TAGALOGFITZGERALD, THERESA M MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000883044NPI: 1508096256FREUND, RACHEL A MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000754743NPI: 1326298407HOING, AMY N MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000117552NPI: 1306872593 This provider is not acceptingnew patients at this time
WASHINGTONBOTHELLFAMILY PRACTICEWASHINGTON (cont'd)BOTHELL (cont'd)FAMILY PRACTICE (cont'd)KAUSHIK, VASUDHA MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000944873NPI: 1992945240Provider Speaks: HINDIKNOX, KRISTEN KAY MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000973252NPI: 1093712010LANEGRAFF, MILLICENTKELLY ARNP1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000973261NPI: 1710984737LARSEN, JANET L MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100001019086NPI: 1356430383LEPPERT, SARAH L PAC1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000883077NPI: 1578800124LIU, KIMBERLY YU YI DO1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000607222NPI: 1467459487Provider Speaks: CANTONESEPrimary Care ProvidersSorted by state, city, specialty, then nameLYDSTON, MICHELLE M PAC1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000944772NPI: 1194746222Provider Speaks: SPANISHMOFFAT, KRISTI S MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000944766NPI: 1962503235MONTAGUE, STEVEN ASHERDO1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000973256NPI: 1629075650PACEM, COLLEEN M ARNP1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000348403NPI: 1497825673PATZ, JOHN DANIEL DO1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000883005NPI: 1073549002RICE, BRIANA L ARNP1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000883025NPI: 1326374877VATHEUER, HANS M MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000522815NPI: 1831280684Provider Speaks: GERMAN11WASHINGTONBOTHELLINTERNAL MEDICINEWALKER, DAVID LEWIS MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000974589NPI: 1619959152Provider Speaks: SPANISHWU, CHIYANG DO1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100001013356NPI: 1760474738ZWILLING, SONIA E MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000645451NPI: 1003904657Provider Speaks: SPANISHINTERNAL MEDICINEBROWN, JAMES D MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000035635NPI: 1659353290GADHOK, RACHNA J MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100000986783NPI: 1639355209KAUR, NAVDEEP MD1909 214TH ST SE STE 110BOTHELL, WA 98021(425) 488-4988Provider ID: 100001039933NPI: 1972745701March 13, 2014
WASHINGTONBOTHELLINTERNAL MEDICINEPrimary Care ProvidersSorted by state, city, specialty, then nameBURDULIS, AUDRA J PAC16850 SE 272ND STCOVINGTON, WA 98042BOTHELL (cont'd)(253) 395-1971INTERNAL MEDICINE (cont'd)Provider ID: 100000108095NPI: 1124075205MORGENROTH, NONNA O MDCHAN, PHILIP YUET HUNG MD1909 214TH ST SE STE 11016850 SE 272ND STBOTHELL, WA 98021COVINGTON, WA 98042(425) 488-4988(253) 395-1971Provider ID: 100000292922Provider ID: 100000284718NPI: 1508953043NPI: 1942231899Provider Speaks: RUSSIAN,Provider Speaks: CHINESEUKRAINIANRITTENBERG, STEVEN WADE CHANG, DAVID Y B MD17700 SE 272ND STMDCOVINGTON, WA 980421909 214TH ST SE STE 110(253) 372-7100BOTHELL, WA 98021Provider ID: 100000055300(425) 488-4988NPI: 1720003114Provider ID: 100000786055Provider Speaks: MANDARIN,NPI: 1851455893TAIWANESESCHIESSER, MICHAEL JOHNCHAUDHARY, ASMITA MDMD16850 SE 272ND ST1909 214TH ST SE STE 110COVINGTON, WA 98042BOTHELL, WA 98021(253) 395-1960(425) 488-4988Provider ID: 100000692056Provider ID: 100000882986NPI: 1861695124NPI: 1215092507CHE, JUNGHEE ARNPProvider Speaks: FRENCH17700 SE 272ND STCOVINGTONCOVINGTON, WA 98042(253) 372-7020FAMILY PRACTICEProvider ID: 100000998559AGAN, WILLIAM A PAC NPI: 114451088416850 SE 272ND STCHEN, HILTON ANTHONY MDCOVINGTON, WA 9804217700 SE 272ND ST(253) 395-1971COVINGTON, WA 98042Provider ID: 100000267894(253) 372-7020NPI: 1134308380Provider ID: 100000998768AVALON, RICHARD OTTO DONPI: 182101792216850 SE 272ND STCONSTANCE, PAULA ANNCOVINGTON, WA 98042ARNP(253) 395-197117700 SE 272ND STProvider ID: 100000245448COVINGTON, WA 98042NPI: 1619930088(253) 372-7020Provider ID: 100000999115NPI: 1437175676WASHINGTON (cont'd)March 13, 201412WASHINGTONCOVINGTONFAMILY PRACTICEDARBY, PHILLIP A PA17700 SE 272ND STCOVINGTON, WA 98042(253) 372-7020Provider ID: 100001000345NPI: 1023037868DE GUZMAN-ABAJERO,MARICAR ONGOCO MD17700 SE 272ND STCOVINGTON, WA 98042(253) 372-7100Provider ID: 100000065916NPI: 1912923053DEALY, RICHARD J ARNP17700 SE 272ND STCOVINGTON, WA 98042(253) 372-7100Provider ID: 100001000626NPI: 1255765541DO, DANG H MD17700 SE 272ND STCOVINGTON, WA 98042(253) 372-7100Provider ID: 100000554925NPI: 1891953766Provider Speaks: VIETNAMESEERICKSEN, SALLY M ARNP17700 SE 272ND STCOVINGTON, WA 98042(253) 372-7100Provider ID: 100001002347NPI: 1528375284ESTRADA, JOEL F MD17700 SE 272ND STCOVINGTON, WA 98042(253) 372-7100Provider ID: 100001002371NPI: 1811040173Provider Speaks: SPANISH,TAGALOGGALLEVO, REMI V MD17700 SE 272ND STCOVINGTON, WA 98042(253) 372-7100Provider ID: 100000249864NPI: 1992992655 This provider is not acceptingnew patients at this time
WASHINGTONCOVINGTONFAMILY PRACTICEPrimary Care ProvidersSorted by state, city, specialty, then nameHEMMEN, GIA LYNN MD16850 SE 272ND STCOVINGTON, WA 98042COVINGTON (cont'd)(253) 395-1971FAMILY PRACTICE (cont'd)Provider ID: 100000277639NPI: 1205858123GOMEZ-VANALLMAN, ALMA EProvider Speaks: SPANISHPACHERMAN, ERIC D MD16850 SE 272ND ST STE 21017700SE 272ND STCOVINGTON, WA 98042COVINGTON, WA 98042(253) 395-2006(253) 372-7100Provider ID: 100000944654Provider ID: 100001003345NPI: 1992720486NPI: 1851483432Provider Speaks: SPANISHHERNER, KIMBERLEYGULUR, DHRUVA R MDKRISTINEMD16850 SE 272ND ST16850SE272NDSTCOVINGTON, WA 98042COVINGTON, WA 98042(253) 395-1971(253) 395-1971Provider ID: 100000795713Provider ID: 100000053205NPI: 1649407016NPI: 1740202514Provider Speaks: KANNADAHOOD, CONSTANCE PAULINEHARKINS, KARYN I MDPAC17700 SE 272ND ST17700 SE 272ND STCOVINGTON, WA 98042COVINGTON, WA 98042(253) 372-7100(253) 372-7100Provider ID: 100000065040Provider ID: 100001003293NPI: 1336231901NPI: 1447342027HARMON, CHRISTINE LOUISEHOOPER, VERONICA J DOMD17700 SE 272ND ST17700 SE 272ND STCOVINGTON, WA 98042COVINGTON, WA 98042(253) 372-7100(253) 372-7100Provider ID: 100001003723Provider ID: 100001003745NPI: 1205861960NPI: 1154417608Provider Speaks: SPANISHHAWKINS, RICHARD SCOTTJOHNS, ALEXINNA C MDMD17700 SE 272ND ST17700 SE 272ND STCOVINGTON, WA 98042COVINGTON, WA 98042(253) 372-7020(253) 372-7020Provider ID: 100001002995Provider ID: 100001003740NPI: 1073731006NPI: 1912925207JONES, LISA A ARNP17700 SE 272ND STCOVINGTON, WA 98042(253) 372-7020Provider ID: 100000879978NPI: 1578808465WASHINGTON (cont'd)13WASHINGTONCOVINGTONFAMILY PRACTICEKALLOCK, ERIN K MD17700 SE 272ND STCOVINGTON, WA 98042(253) 372-7020Provider ID: 100001002379NPI: 1053574335Provider Speaks: SPANISHKONG, NATALIE K A MD17700 SE 272ND STCOVINGTON, WA 98042(253) 372-7020Provider ID: 100001002880NPI: 1457678351LEW JR, ARTHUR MD16850 SE 272ND STCOVINGTON, WA 98042(253) 395-1971Provider ID: 100000083109NPI: 1235153024LUTES, MARIA L ARNP17700 SE 272ND STCOVINGTON, WA 98042(253) 403-4613Provider ID: 100000991602NPI: 1881911659MARKEGARD, SHANNON
Provider Directory This directory provides a list of Regence BlueAdvantage HMO's network providers. This directory is for King, Pierce, and Snohomish Counties in the state of Washington. This directory is current as of March 13, 2014. Some network providers may have been added or removed from our network after this directory was printed.
