PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1003906918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003906918 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Other Organization Name | PROVIDENCE SOUNDHOMECARE AND HOSPICE |
| Practice Address |
3432 Bay Rd Ne Olympia WA 98506-2958 |
| Mailing Address |
Po Box 5008 Lacey WA 98509-5008 |
| Practice Telephone | 3604598311 |
| Practice Fax Number | 3604934657 |
| Mailing Telephone | 3604598311 |
| Mailing Fax Number | 3604934657 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2008-10-02 |
| Authorized Official Name | ROBERT HELLRIGEL (CEO) |
| Authorized Official Telephone | 4252545432 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | WA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7402688 | 05 |
| Other Name | Type Code |
|---|---|
| Providence SoundHomecare and Hospice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407162571 | Providence Health & Services - Washington | Internal Medicine | 510 E Amende Drive, Odessa, WA 99159-0000 | 2010-08-26 |
| 1841503034 | Providence Health & Services - Washington | Family Medicine | 18313 Paulsonst Sw, Suite A, Rochester, WA 98579-9262 | 2010-07-16 |
| 1083947709 | Providence Health & Services - Washington | Hospice Care, Community Based | 2731 Wetmore Ave Ste 500, Everett, WA 98201-3585 | 2009-09-14 |
| 1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
| 1558512368 | Providence Health & Services - Washington | Home Health | 209 W Poplar St, Walla Walla, WA 99362 | 2008-10-10 |
| 1922259738 | Providence Health & Services - Washington | Internal Medicine | 380 Chase Avenue, Pmg Se Wa, Walla Walla, WA 99362-2924 | 2008-10-10 |
| 1306097126 | Providence Health & Services - Washington | Radiology | 401 W Poplar Street, Pmg Se Wa Imaging, Walla Walla, WA 99362-2846 | 2008-10-10 |
| 1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
| 1073677605 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 506 W Franklin St, Shelton, WA 98584-3517 | 2006-12-20 |
| 1376638171 | Providence Health & Services - Washington | Skilled Nursing Facility | 4900 Eagle St, Anchorage, AK 99503-7446 | 2006-10-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
3432 BAY RD NE |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-2958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982026985 | Petrina Gavrilis Fnp-bc Arnp Family Health Care Services, LLC | Home Health | 6141 Kiel Ct Se, Olympia, WA 98513-6539 | 2014-01-09 |
| 1518314459 | Energy Employee Home Health Services, LLC | Home Health | 1115 W Bay Dr Nw, Olympia, WA 98502-4658 | 2016-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433481 | Malaika Home Care LLC | Home Health | 10518 N Russett Dr, Spokane, WA 99208-6729 | 2020-09-30 |
| 1619582632 | Flowing Water Venture Inc. | Home Health | 23453 16th Ave S Apt A304, Des Moines, WA 98198-8042 | 2020-09-15 |
| 1477163236 | Pnw Kupuna Care, LLC | Home Health | 203 S 4th Ave, Sequim, WA 98382-3719 | 2020-08-06 |
| 1538778295 | Eden Home Health of Clark County, LLC | Home Health | 4601 Ne 77th Ave Ste 300, Vancouver, WA 98662-6736 | 2020-07-29 |
| 1033736160 | Home Health Seattle LLC | Home Health | 19803 1st Ave S Ste 200, Normandy Park, WA 98148-2410 | 2020-07-06 |
| 1265053920 | Premier Care Services | Home Health | 13555 Ne Bel Red Rd Ste 113, Bellevue, WA 98005-2324 | 2020-05-04 |
| 1861011330 | Samuel Kihiu Njenga | Home Health | 3607 27th St Se, Puyallup, WA 98374-1716 | 2020-04-14 |
| 1972136745 | Tender Angels Home Care | Home Health | 11900 Ne 1st St Bldg G, Bellevue, WA 98005-3046 | 2020-02-19 |
| 1154953628 | Meliorahealthcare Pllc | Home Health | 17539 10th Ave Nw, Shoreline, WA 98177-3804 | 2020-02-12 |
| 1235786781 | Ahhpc, Inc. | Home Health | 907 W Boone Ave Ste B, Spokane, WA 99201-2503 | 2019-08-20 |
| 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.