PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1053618892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053618892 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Other Organization Name | PROVIDENCE PULMONARY ONCOLOGY |
| Practice Address |
105 W 8th Ave Ste 550e Spokane WA 99204-2302 |
| Mailing Address |
101 W 8th Ave Mother Gamelin Center, 3rd Floor Spokane WA 99204-2307 |
| Practice Telephone | 5094745589 |
| Practice Fax Number | 5094742661 |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2011-02-18 |
| Authorized Official Name | ANSELMO NUNEZ (CHIEF EXECUTIVE) |
| Authorized Official Telephone | 5094746616 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Pulmonary Oncology | 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 |
| 1356646202 | Providence Physician Services Co | Surgery | 122 W 7th Ave, Ste 420, Spokane, WA 99204-2349 | 2011-01-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE PHYSICIAN SERVICES CO. | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Street Address |
105 W 8TH AVE STE 550E |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972506814 | Jennifer Kay Pary | Psychiatry & Neurology | 105 W 8th Ave, Suite 318c, Spokane, WA 99204-2302 | 2005-05-24 |
| 1285191346 | Lauren A Earthman | Physician Assistant | 105 W 8th Ave, Spokane, WA 99204-2302 | 2019-02-25 |
| 1285104885 | Jonathan Carmen Panetta | Nurse Practitioner | 105 W 8th Ave, Spokane, WA 99204-2302 | 2018-11-27 |
| 1821516949 | Hayden Ingram | Pharmacist | 105 W 8th Ave, Spokane, WA 99204-2302 | 2017-09-08 |
| 1326573031 | Charlotte Lynch | Advanced Practice Midwife | 105 W 8th Ave, Suite 6020, Spokane, WA 99204-2302 | 2017-05-01 |
| 1336698703 | Jocelyn Diana Christianson | Counselor | 105 W 8th Ave, Suite 332, Spokane, WA 99204-2302 | 2016-09-27 |
| 1972057172 | Ashlee Nicole Bradshaw | Counselor | 105 W 8th Ave, Suite 332, Spokane, WA 99204-2302 | 2016-08-05 |
| 1720439045 | Kristin Martin | Nurse Practitioner | 105 W 8th Ave, Suite 200, Spokane, WA 99204-2302 | 2016-06-28 |
| 1871940809 | Elizabeth Killian | Counselor | 105 W 8th Ave, Ste.332, Spokane, WA 99204-2302 | 2016-05-19 |
| 1962860981 | Mahshid Aghasadeghi | Registered Nurse | 105 W 8th Ave, Suite 6020, Spokane, WA 99204-2302 | 2016-02-04 |
| 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 | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215363676 | Lawrence Edward Klock Jr. | Internal Medicine | 4115 S Bellgrove Ln, Spokane, WA 99223-6185 | 2013-09-17 |
| 1649439209 | Allison A Lambert | Internal Medicine | 105 W 8th Ave Ste 660e, Spokane, WA 99204-2302 | 2008-06-08 |
| 1891737748 | Griffith E Liang | Internal Medicine | 105 W 8th Ave Ste 512c, Spokane, WA 99204-2318 | 2006-06-12 |
| 1437593175 | Angela Olson | Internal Medicine | 910 W 5th Ave Ste 1001, Spokane, WA 99204-2976 | 2013-04-24 |
| 1023374113 | Benjamin James Arthurs | Internal Medicine | 910 W 5th Ave Ste 1001, Spokane, WA 99204-2976 | 2012-04-03 |
| 1396062022 | Providence Physician Services Co | Internal Medicine | 212 E Central Ave, Ste 315, Spokane, WA 99208-6291 | 2010-04-20 |
| 1043535370 | Thomas Warren Decato | Internal Medicine | 212 E Central Ave Ste 315, Spokane, WA 99208 | 2010-03-30 |
| 1528126927 | Medical Specialists of Spokane Pllc | Internal Medicine | 104 W 5th Ave, Suite 400w, Spokane, WA 99204-4880 | 2006-12-05 |
| 1124136692 | North Spokane Pulmonary Clinic, P.s. | Internal Medicine | 212 E Central Ave, Suite 315, Spokane, WA 99208-6291 | 2006-08-26 |
| 1306836499 | Gregory M Loewen | Internal Medicine | 105 W 8th Ave, Suite 550, Spokane, WA 99204 | 2005-10-28 |
| Find all providers in SPOKANE | ||||
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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.