PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1003133760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003133760 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Other Organization Name | PPS PSHMC SUPPORTIVE CARE SERVICES |
| Practice Address |
101 W 8th Ave Center for Faith and Healing Spokane WA 99204-2307 |
| Mailing Address |
101 W 8th Ave Mother Gamelin Center, 3rd Floor Spokane WA 99204-2307 |
| Practice Telephone | 5094743008 |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2011-02-28 |
| Authorized Official Name | ANSELMO NUNEZ (CHIEF EXECUTIVE) |
| Authorized Official Telephone | 5094746616 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PPS PSHMC SUPPORTIVE CARE SERVICES | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740566173 | Providence Physician Services Co | Internal Medicine | 212 Central Ave Suite 440, Spokane, WA 99208 | 2011-10-31 |
| 1295016145 | Providence Physician Services Co | Family Medicine | 801 W. 5th Ave, Suite 307, Spokane, WA 99204 | 2011-09-06 |
| 1619268281 | Providence Physician Services Co | Family Medicine | 100 W. South Ave Chewelah, Chewelah, WA 99109 | 2011-04-29 |
| 1184915829 | Providence Physician Services Co | Family Medicine | 5011 W. Lowell Ave, Seattle, WA 99208-8587 | 2011-04-28 |
| 1578869913 | Providence Physician Services Co | Family Medicine | 12704 E Nora Ave, Ste B, Spokane Valley, WA 99216-1140 | 2011-02-02 |
| 1891001277 | Providence Physician Services Co | Pediatrics | 5901 N Linderwood, Suite 126, Spokane, WA 99207 | 2010-08-24 |
| 1245557917 | Providence Physician Services Co | Obstetrics & Gynecology | 518 Clay Street, Chewelah, WA 99109 | 2010-04-21 |
| 1215223953 | Providence Physician Services Co | Prosthetic/Orthotic Supplier | 101 W 8th Ave, Mother Gamelin Center, 3rd Floor, Spokane, WA 99204-2307 | 2011-06-21 |
| 1336433812 | Providence Physician Services Co | Family Medicine | 104 W 5th Ave, Suite 390e, Spokane, WA 99204 | 2011-06-02 |
| 1053618892 | Providence Physician Services Co | Internal Medicine | 105 W 8th Ave, Ste 550e, Spokane, WA 99204-2302 | 2011-02-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE PHYSICIAN SERVICES CO. | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Street Address |
101 W 8TH AVE CENTER FOR FAITH AND HEALING |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003819319 | Sacred Heart Medical Center | General Acute Care Hospital | 101 W 8th Ave, Spokane, WA 99204-2307 | 2005-05-31 |
| 1124626841 | Melissa Ann Benson | Respiratory Therapist, Registered | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-10-14 |
| 1184236671 | Margaret Ann Warren | Physical Therapist | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-08-18 |
| 1265044747 | Melyssa Carlson | Registered Nurse | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-08-17 |
| 1760091276 | Corle Morefield | Pharmacist | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-07-30 |
| 1174143663 | Ashley Kay Gardiner | Student in an Organized Health Care Education/Training Program | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-24 |
| 1265061485 | Mary Katherine Griessmann | Social Worker | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-08 |
| 1558990994 | Ingrid Mary Agnew | Social Worker | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-07 |
| 1952930562 | Cody Key | Student in an Organized Health Care Education/Training Program | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-06 |
| 1417586173 | Samuel Logan | Student in an Organized Health Care Education/Training Program | 101 W 8th Ave, Spokane, WA 99204-2307 | 2020-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 207RH0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hospice and Palliative Medicine |
| An internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
| Notes: Source: American Academy of Hospice and Palliative Medicine, www.aahpm.org [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669975280 | Mid-south Home Care Services, LLC | Internal Medicine | 22820 E Appleway Ave Ste C, Liberty Lake, WA 99019-9514 | 2018-03-09 |
| 1609843382 | Karen Knops | Internal Medicine | 1035 116th Ave Ne, Bellevue, WA 98004-4604 | 2006-03-02 |
| 1851373799 | Laura Schellenberg Johnson | Internal Medicine | 12040 Ne 128th St # Ms 105, Kirkland, WA 98034-3013 | 2005-11-16 |
| 1043637408 | Nauzley Christy Abedini | Internal Medicine | 325 9th Ave, Seattle, WA 98104-2420 | 2014-03-24 |
| 1952689077 | Matthew W Louie | Internal Medicine | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2011-07-22 |
| 1952537565 | Kathryn Ann Vogelsang Schlenker | Internal Medicine | 1959 Ne Pacific St, Box 356390, Seattle, WA 98195-0001 | 2009-06-09 |
| 1104014364 | Sarah B Merrifield | Internal Medicine | 413 Lilly Rd Ne, Palliative Care, Olympia, WA 98506-5133 | 2007-10-11 |
| 1346432721 | Tula Top | Internal Medicine | 2211 Ne 139th St, Vancouver, WA 98686-2742 | 2007-08-09 |
| 1093906026 | Caroline Jeanette Hurd | Internal Medicine | 325 9th Ave, Seattle, WA 98104-2420 | 2007-08-06 |
| 1477751139 | Meredith Blayne Brass | Internal Medicine | 12822 124th Ln Ne, Kirkland, WA 98034-7612 | 2007-07-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.