PROVIDENCE HEALTH & SERVICES-WA (NPI# 1114236791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114236791 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES-WA |
| Other Organization Name | PMG NW WA CARDIOVASCULAR AND THORACIC SURGERY |
| Practice Address |
1330 Rockefeller Avenue Suite 400 Everett WA 98201-1676 |
| Mailing Address |
Po Box 3360 Portland OR 97208-3360 |
| Practice Telephone | 4252614950 |
| Practice Fax Number | 4252614951 |
| Mailing Telephone | 8663662983 |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2015-05-19 |
| Authorized Official Name | PAULA WOOD (PROVIDER CONCIERGE) |
| Authorized Official Telephone | 4252614082 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PMG NW WA Cardiovascular and Thoracic Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588294854 | Providence Health & Services-wa | Clinic/Center | 916 Pacific Ave, Everett, WA 98201-4147 | 2020-01-24 |
| 1649615220 | Providence Health & Services-wa | Naturopath | 1321 Colby Ave, Everett, WA 98201-1665 | 2013-05-08 |
| 1215225099 | Providence Health & Services-wa | Midwife | 14692 179th Ave Se, Ste 800, Monroe, WA 98272-1162 | 2011-07-14 |
| 1447547658 | Providence Health & Services-wa | Registered Nurse | 14692 179th Ave Se, Ste 800, Monroe, WA 98272-1162 | 2011-07-08 |
| 1891088845 | Providence Health & Services-wa | Pharmacy | 3305 Nassau St # 101, Everett, WA 98201-4140 | 2011-05-24 |
| 1831499755 | Providence Health & Services-wa | Orthopaedic Surgery | 1330 Rockefeller Ave, Suite 225, Everett, WA 98201-1684 | 2010-10-26 |
| 1972819175 | Providence Health & Services-wa | Registered Nurse | 3305 Nassau St, Everett, WA 98201-4140 | 2010-08-25 |
| 1164747242 | Providence Health & Services-wa | General Practice | 1717 13th Street, Everett, WA 98201-1621 | 2010-04-01 |
| 1346571841 | Providence Health & Services-wa | Nurse Practitioner | 1330 Rockefeller, Suite 200, Everett, WA 98201-1677 | 2010-01-22 |
| 1255664652 | Providence Health & Services-wa | Obstetrics & Gynecology | 900 Pacific Ave, Suite 501, Everett, WA 98201-4147 | 2009-09-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Providence Health & Services-Washington | 1801 Lind Ave Sw #9016, Renton, Washington 98057-9016 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES-WASHINGTON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES-WASHINGTON | 1801 Lind Ave Sw #9016, Renton, WA 98057-3368 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES-WASHINGTON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
| Street Address |
1330 ROCKEFELLER AVENUE SUITE 400 |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-1676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306471867 | Shannon Michelle Dewald | Registered Nurse | D8s 1700 13th St, Everett, WA 98201 | 2020-03-05 |
| 1578123113 | Precious Medicial Spa, LLC | Registered Nurse | 1728 W. Marine View Dr Suite 212, Everett, WA 98201 | 2019-06-17 |
| 1508429796 | Alix Deschain | Counselor | 2801 Broadway, Everett, WA 98201 | 2019-04-15 |
| 1811457534 | Khushboo Patel | Pharmacist | 1330 Rockefeller Ave Ste 150, Everett, WA 98201 | 2019-03-20 |
| 1164991188 | Grace Talbot Davis | Registered Nurse | 2601 Summit Avenue, Bldg. C, Everett, WA 98201 | 2018-11-20 |
| 1063924603 | Tracy Sisk | Counselor | 3120 Colby Ave, 502, Everett, WA 98201 | 2017-11-03 |
| 1710403126 | Michelle Durham | Counselor | 3322 Boadway Fl 2, Everett, WA 98201 | 2017-08-17 |
| 1861927949 | Melanie Schmidt | Counselor | 2610 Westmore Ave, Everett, WA 98201 | 2017-04-26 |
| 1518413327 | Joseph Madson Dmd Pllc | Clinic/Center | 3802 Colby Ave, 4th Floor, Everett, WA 98201 | 2016-08-31 |
| 1043683162 | Jennifer Adams | Counselor | 1511 26th St, Everett, WA 98201 | 2015-11-11 |
| Find all providers in zip 98201 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801038161 | Shaina Marie Schaetzel | Surgery | 1300 Rockefeller Ave, Suite 120, Everett, WA 98201 | 2009-04-01 |
| 1225256720 | Western Washington Medical Group | Surgery | 3216 Norton Ave Ste 202, Everett, WA 98201-4290 | 2007-04-23 |
| 1336214014 | Sidney Schwab | Surgery | 3825 Shore Ave, Everett, WA 98203-1228 | 2006-11-21 |
| 1962415430 | Prabhat Kumar Bhama | Surgery | 1330 Rockefeller Ave Ste 310, Everett, WA 98201-1677 | 2006-08-14 |
| 1053328997 | John L Goodman | Surgery | 1330 Rockefeller Ave Ste 120, Everett, WA 98201-1676 | 2006-08-02 |
| 1073580395 | Bedford Surgical Associates, Inc. | Surgery | 283 Hospital Drive, Everett, PA 15537-7020 | 2006-03-06 |
| 1912984832 | Nicole Norris Debolt | Surgery | 283 Hospital Dr, Everett, PA 15537-7020 | 2005-12-30 |
| 1588051494 | Luis Fernando Alberton | Surgery | 1330 Rockefeller Ave, Ste 400, Everett, WA 98201-1684 | 2015-04-17 |
| 1205222551 | Patrick Willauer | Surgery | 1330 Rockefeller Ave, Everett, WA 98201-1684 | 2015-04-14 |
| 1457793390 | Bariatric Surgery Clinic Trust | Surgery | 12728 19th Ave Se, Suite 200, Everett, WA 98208-6526 | 2013-07-19 |
| Find all providers in EVERETT | ||||
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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.