Clinic visits, types and rates


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I do not accept insurance of any kind in the Bremerton. Payment is due at the time of service to eliminate the need for billing and required staff. This keeps your costs down. Accepted forms of payment: cash, money orders, debit/credit cards. No personal checks. Please have exact change if paying in cash.

All visits will receive a billing slip receipt you may send to your insurance for reimbursement or applied to your annual deductible. My clinic visit rates are less than your insurance reimbursements and should not create an issue for your reimbursement, however if your insurance will not reimburse you because I am an out of network provider, your payments can be applied to your deductible. I want to charge what is a fair rate but not have the hassle of insurance and this is why I will not be accepting insurance even though they would provide a higher rate of reimbursement.

Insurance is accepted at the PacMed sites (Pacific Medical Center).

Internal Medicine consultations
BREMERTON: These type of appointments are for those who want assistance with diabetes management, cardiovascular lipid and risk assessments and counseling, or for those who want a second opinion on their present health issues and management. It is important to understand that this is not a primary care clinic. I am not available to see you on a regular basis and manage all your health issues like your primary care physician can. This clinic is for consultation only where recommendations for treatment and some prescribing can be offered, but on a limited, quarterly basis. I can coordinate treatment with your primary care provider if they are open to this approach.

This is not a chronic pain clinic and no narcotics or opioids will be prescribed. I can consult as to why you are having chronic pain and recommend alternative and complimentary treatments. I do not prescribe marijuana in any form.

Rate $300 for first appointment includes 60 min office visit plus 1 hr of chart review/research after appt; $150/hr thereafter. Followups are billed in 20 min increments:
20mins $50
40 mins $100
60 mins $150.
Note that more than 1 problem needing to be addressed automatically puts you in the $100 rate even if it only takes 20 mins to see you due to the complexity of the visit.

PACMED PUYALLUP:
253-435-3456
220 15th Ave SE, suite C
Puyallup, WA
I am in this clinic on a part-time basis and available for Internal Medicine consultation . If you wish to establish primary care here, you will be assigned a PCP from this clinic but you may still see me by request. You will see your PCP when I am out.

Transgender clinic
there are  2 options available for transgender care,
1) in Bremerton cash only 360-548-2823
2) in Puyallup at Pacific Medical Center where you may use your insurance 253-435-3456

Consultation is available to those seeking information about transitioning, even if you are not ready to transition yet. Hormone treatment for those who meet criteria is available for ages 15 and up. Parents must be in attendance and supportive for all those under 18. Your first appointment will review your general health, and lab work and an exam will be performed. Chronic health issues do not prevent you from receiving treatment and transitioning, but they must be stable. For those seeking hormones, please  bring or have sent (mail or fax) your mental health provider’s/sexologist’s evaluation. For those seeking information and consultation only, these are not required. Post op care is available, as is STI (sexually transmitted infection) assessments and PrEP therapy.

1) for Bremerton:  Rate $150 for first appointment. Followup is
0-30 mins $75
30-45 mins $100
up to 60 mins $150
If we find some health issues that are not strictly transgender related and need to be addressed, this will put you into the more complex category until these are stable and will be $100 minimum. Most TG followup appointments will be straight forward and only $75.

3) for Puyallup:
253-435-3456
220 15th Ave SE, Suite C
Puyallup, WA 98372
PUYALLUP, WA- the phone number listed here is a direct phone number to avoid the central scheduling operator. This number goes directly to the clinic to staff who have been trained in TG care. They will ask a series of questions necessary to facilitate your appointment process. This information is kept in the clinic for my use. I am in this clinic  M, T, W 3 weeks most months. It is easy to find the clinic, 60-90 min drive from Bremerton.  Advantages of this clinic is you can use your insurance, and you can have a trans friendly PCP here.  PacMed Puyallup offers family medicine providers who can see pediatric patients.  I can treat all trans patients ages 15 +, and primary care ages 18+.

ALTERNATE INTEGRATIVE HEALING*

Crystal Bed

Energy work
Energy sessions are by appointment with me only after consultation.

*see Alternative Integrative Healing page for info about these services