PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI# 1023563897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023563897 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES WASHINGTON |
| Other Organization Name | PROVIDENCE HEALTH & SERVICES WASHINGTON (PMG SE WA) - EXPRESS CARE |
| Practice Address |
1705 Se Meadowbrook Blvd Suite 2 College Place WA 99324-1756 |
| Mailing Address |
Po Box 32 Liberty Lake WA 99019-0032 |
| Practice Telephone | 5099872450 |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2017-11-26 |
| Authorized Official Name | DONALD W ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Health & Services Washington (PMG SE WA) - Express Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134656135 | Providence Health & Services Washington | Clinic/Center | 1018 Capitol Way S Ste 300, Olympia, WA 98501-1212 | 2017-05-22 |
| 1023550050 | Providence Health & Services Washington | Psychologist | 225 State Ave Ne, Olympia, WA 98501-6951 | 2016-11-08 |
| 1003367863 | Providence Health & Services Washington | Radiology | 4800 College St Se Ste E, Lacey, WA 98503-4389 | 2016-10-17 |
| 1457721250 | Providence Health & Services Washington | Clinic/Center | 1200 Basich Blvd, Aberdeen, WA 98520-1035 | 2015-10-06 |
| 1902141500 | Providence Health & Services Washington | Clinical Medical Laboratory | 820 S Mcclellan St Ste Ll10, Spokane, WA 99204-2446 | 2012-12-07 |
| 1881907715 | Providence Health & Services Washington | Internal Medicine | 62 W 7th Ave, Spokane, WA 99204-2321 | 2010-07-20 |
| 1073744850 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 2505 Olympic Hwy N., Ste 140, Shelton, WA 98584-2978 | 2009-07-28 |
| 1770714693 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 508 1/2 Eighth Street, Hoquiam, WA 98550-3521 | 2009-07-28 |
| 1033309604 | Providence Health & Services Washington | Family Medicine | 1450 Northwest Lane Se, Lacey, WA 98503-6908 | 2007-07-30 |
| 1407055759 | Providence Health & Services Washington | Rehabilitation Unit | 410 Providence Ln., Building 2, Olympia, WA 98506-5101 | 2007-07-17 |
| Street Address |
1705 SE MEADOWBROOK BLVD SUITE 2 |
| City | COLLEGE PLACE |
| State | WA |
| Zip Code | 99324-1756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851885107 | Comprehensive Healthcare | Community Based Residential Treatment Facility, Mental Illness | 1250 Se Commercial Dr, College Place, WA 99324 | 2018-06-20 |
| 1477051415 | Carrie Jean White | Counselor | 56 N College Ave #2a, College Place, WA 99324 | 2018-01-24 |
| 1952824658 | Ashley Bergmann | Social Worker | 1928 George Washington Way, Apt L1, Richland, WA 99324 | 2017-07-25 |
| 1376081224 | Ariel Anderson | Registered Nurse | 1755 College Ave, College Place, WA 99324 | 2017-02-10 |
| 1770926644 | Richard Kearns | Registered Nurse | 800 Se Sentry Dr, College Place, WA 99324 | 2013-04-10 |
| 1619259009 | Debra Jean Maxted | Physical Therapy Assistant | 420 Se Myra Road, College Place, WA 99324 | 2011-09-13 |
| 1740470533 | Danny R. Croft | Denturist | 1298 Se 12th Street, College Place, WA 99324 | 2007-07-27 |
| 1316059983 | Mary Ellen Hustead | Social Worker | 325 Sprucewood Place, College Place, WA 99324 | 2006-08-31 |
| 1639158264 | Elizabeth Ann Wall | Nurse Practitioner | 722 South College Avenue, College Place, WA 99324 | 2006-01-12 |
| 1013494640 | Amber Hopkins | Case Manager/Care Coordinator | 1250 Se Commercial Dr, College Place, WA 99324 | 2018-07-26 |
| Find all providers in zip 99324 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063971703 | Source Northwest Integrative Medicine | General Practice | 7206 267th St Nw Ste 102, Stanwood, WA 98292-6269 | 2019-03-12 |
| 1255896601 | Emily Christine Buck | General Practice | 940 Fitzsimmons Dr, Tacoma, WA 98431-0001 | 2019-02-08 |
| 1740755651 | Alyssa Ann Yruegas | General Practice | 2108 W Spruce St, Moses Lake, WA 98837-2853 | 2018-10-06 |
| 1306321237 | Rainier Springs Physician Group, LLC | General Practice | 2805 Ne 129th Street, Vancouver, WA 98686 | 2018-09-26 |
| 1962916437 | Parkview Medical Group Inc | General Practice | 615 S Division St Ste A, Moses Lake, WA 98837-3800 | 2017-11-20 |
| 1790212496 | Thien Thanh Ho | General Practice | 12307 Douglas Rd, Yakima, WA 98908-9129 | 2017-05-12 |
| 1285173625 | Regenerative Medicine Institute, Pllc | General Practice | 731 N Stanley St, Medical Lake, WA 99022-8940 | 2017-02-17 |
| 1457708430 | James Bailey | General Practice | 9040 Jackson Ave Tripler Army Medical Center, Tacoma, WA 98431-5001 | 2016-05-19 |
| 1740635887 | Peter Chulhi Kang | General Practice | 1425 Spring St Apt 802, Seattle, WA 98104-1635 | 2016-04-26 |
| 1831551084 | Anna Hackenmiller | General Practice | 1657 S Nettleton Ln, Spokane, WA 99224-6108 | 2016-03-27 |
| Find all providers with the same taxonomy | ||||
| City | COLLEGE PLACE |
| Zip Code | 99324 |
Please comment or provide details below to improve the information on PROVIDENCE HEALTH & SERVICES WASHINGTON.
| 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.