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SHJ25-011 UNITED HEALTHCARE & KCJ Carceral 2025 Medicaid Contract - PARTIALLY EXECUTED
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08. August
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2025-08-05 10:00 AM - Commissioners' Agenda
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SHJ25-011 UNITED HEALTHCARE & KCJ Carceral 2025 Medicaid Contract - PARTIALLY EXECUTED
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Last modified
7/31/2025 12:08:07 PM
Creation date
7/31/2025 12:03:50 PM
Metadata
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Template:
Meeting
Date
8/5/2025
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Item
Request to Acknowledge the Contract between the Kittitas County Jail and United Healthcare
Order
8
Placement
Consent Agenda
Row ID
133785
Type
Contract
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Appendix 3 <br />Your Professional Staff <br />Appendix 3 PHYSICIAN ROSTER <br />Practitioner <br />NPI <br />Last Name <br />First Name <br />License <br />Number <br />License <br />State <br />License <br />Issue Date <br />License <br />Expiration <br />Date <br />1073005443 <br />Deffinbaugh <br />Zachary <br />AP61000053 <br />WA <br />9/18/2019 <br />7/28/2026 <br />1154590479 <br />Long <br />Aaron <br />AP60298635 <br />WA <br />7/30/2612 <br />4/1/2027 <br />1083957468 <br />Fernandez <br />Sergio <br />AP60346231 <br />WA <br />3/14/2613 <br />3/-6/2026 <br />1811784267 <br />Munguia <br />Cynthia <br />RN61578167 <br />WA <br />7/12/2024 <br />9/10/2025 <br />1972390334 <br />Loen <br />Christine <br />RN00127797 <br />WA <br />8/22/1997 <br />7/5/2026 <br />1942098843 <br />McHargue <br />Jenny <br />LP00046245 <br />WA <br />9/11/1996 <br />06/01/2026 <br />1750911152 <br />Drummond <br />Rachel <br />RN60225547 <br />WA <br />7/13/2011 <br />9/27/2027 <br />1073309514 <br />Leonard <br />Lisa <br />RN00168777 <br />WA <br />12/19/2006 <br />7/24/2026 <br />UbICISMGA.03.12.WA Parties bound to confidentiality under Section 'About data and confidentiality' <br />-15- <br />
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