MEDICARE: WHIDBEY MEDICAL CLINIC PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician
3	261Q00000X	Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CC9056	OTHER	WA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	S57923	OTHER	WA	BLUE CROSS/SHIELD

General Provider Information

NPI Number	:	1548260177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHIDBEY MEDICAL CLINIC PLLC

Provider Business Mailing Address
First Line	:	231 SE BARRINGTON DR
Second Line	:	SUITE 209
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3200
Country	:	US
Telephone Number	:	360-679-3161
Fax Number	:	360-679-1741

Provider Business Practice Location Address
First Line	:	231 SE BARRINGTON DR
Second Line	:	SUITE 209
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3200
Country	:	US
Telephone Number	:	360-679-3161
Fax Number	:	360-679-1741

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT L LYCKSELL
Credential	:	M.D.
Telephone Number	:	360-679-3161

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	12/04/2009

Similar Medicare Providers

1447249222 — TERRY J LEE MD
Practice Location Address:

231 SE BARRINGTON DR , STE 208
OAK HARBOR, WA
98277-3200

Practice Phone: 360-240-2020
Practice Fax: 360-240-1989

1427013473 — DR. ROBERT WILLIAM JOHNSON M.D.
Practice Location Address:

231 SE BARRINGTON DR , SUITE 208
OAK HARBOR, WA
98277-3200

Practice Phone: 360-240-2020
Practice Fax: 360-240-1989

1346436029 — DR. MARGARET G POTCHATEK PSY. D.
Practice Location Address:

231 SE BARRINGTON DR , SUITE 201
OAK HARBOR, WA
98277-3200

Practice Phone: 360-675-9545
Practice Fax:

1326207523 — MRS. JENNIFER LEE LABESKY-WALTERS B.A.
Practice Location Address:

231 SE BARRINGTON DR , SUITE 202
OAK HARBOR, WA
98277-3200

Practice Phone: 360-279-1905
Practice Fax: 360-279-9459

1760620504 — DR. L KATHLEEN SWANSON PSY.D.
Practice Location Address:

231 SE BARRINGTON DR , SUITE 201
OAK HARBOR, WA
98277-3200

Practice Phone: 360-672-1772
Practice Fax:

1750520144 — DESTINY LEANN SCHROLL
Practice Location Address:

231 SE BARRINGTON DR , SUITE 203
OAK HARBOR, WA
98277-3200

Practice Phone: 866-240-0808
Practice Fax: 866-240-0809

Directions to “WHIDBEY MEDICAL CLINIC PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.