Provider Demographics
NPI:1033191903
Name:LOVEGOOD, SAMAYA CASSANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMAYA
Middle Name:CASSANDRA
Last Name:LOVEGOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SAMAYA
Other - Middle Name:MERCEDES SARUBBI
Other - Last Name:PATERAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:P.O. BOX 800
Mailing Address - Street 2:
Mailing Address - City:MEDICAL LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99022-0800
Mailing Address - Country:US
Mailing Address - Phone:509-565-4079
Mailing Address - Fax:509-565-4705
Practice Address - Street 1:850 MAPLE STREET
Practice Address - Street 2:
Practice Address - City:MEDICAL LAKE
Practice Address - State:WA
Practice Address - Zip Code:99022-0800
Practice Address - Country:US
Practice Address - Phone:509-565-4000
Practice Address - Fax:509-565-4705
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000366752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5357603Medicaid
WAH30813Medicare UPIN
WAAB18649Medicare PIN