PROVIDENCE HEALTH & SERVICES - WA (NPI# 1124279237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124279237 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WA |
| Other Organization Name | PMG NW WA - HARBOUR POINTE |
| Practice Address |
4112 Harbour Pointe Blvd Sw Suite 100 Mukilteo WA 98275-5457 |
| Mailing Address |
Po Box 3360 Portland OR 97208-3360 |
| Practice Telephone | 4253476330 |
| Practice Fax Number | 4253476335 |
| Mailing Telephone | 8663992983 |
| Enumeration Date | 2008-10-07 |
| 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 |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PMG NW WA - Harbour Pointe | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215189808 | Providence Health & Services - Wa | Home Health | 1000 N Argonne Rd, Spokane Valley, WA 99212 | 2008-10-15 |
| 1750783759 | Providence Health & Services - Wa | Pharmacy | 916 Pacific Ave, Everett, WA 98201-4147 | 2014-09-22 |
| 1972927267 | Providence Health & Services - Wa | Emergency Response System Companies | 2731 Wetmore Ave, Suite 500, Everett, WA 98201-3571 | 2014-02-07 |
| 1770877227 | Providence Health & Services - Wa | General Practice | 1830 Bickford Ave, Suite 211, Snohomish, WA 98290-1749 | 2011-06-01 |
| 1639468259 | Providence Health & Services - Wa | Orthopaedic Surgery | 1717 13th St, Suite 401, Everett, WA 98201-1621 | 2011-04-05 |
| 1225335425 | Providence Health & Services - Wa | Surgery | 1330 Rockefeller Ave, Ste 520, Everett, WA 98201-1684 | 2011-02-24 |
| 1649402231 | Providence Health & Services - Wa | Social Worker | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2009-08-14 |
| 1861622557 | Providence Health & Services - Wa | Social Worker | 12800 Bothell Everett Hwy, Suite 110, Everett, WA 98208-6642 | 2009-07-16 |
| 1265669451 | Providence Health & Services - Wa | Clinic/Center | 101 W 8th Ave, Women's Health Center, Spokane, WA 99204-2307 | 2009-06-16 |
| 1669616363 | Providence Health & Services - Wa | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2009-04-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
4112 HARBOUR POINTE BLVD SW SUITE 100 |
| City | MUKILTEO |
| State | WA |
| Zip Code | 98275-5457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760474738 | Chiyang Wu | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2005-08-16 |
| 1144662008 | Rolana O Mesias | Registered Nurse | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2013-07-20 |
| 1467728964 | Sabrina Middleton | Pediatrics | 4112 Harbour Pointe Blvd Sw, Ste 100, Mukilteo, WA 98275-5457 | 2012-03-29 |
| 1639481500 | Dean Nair | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2010-07-08 |
| 1669616363 | Providence Health & Services - Wa | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2009-04-24 |
| 1003050709 | Providence Health & Services - Wa | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite100, Mukilteo, WA 98275-5457 | 2009-04-24 |
| 1700037199 | Providence Health & Services-wa | Clinic/Center | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2008-10-04 |
| 1366602468 | Poonam Rauniyar | Pediatrics | 4112 Harbour Pointe Blvd Sw, Ste 100, Mukilteo, WA 98275-5457 | 2008-06-11 |
| 1568644607 | Rajasri Dharani Palepu | Internal Medicine | 4112 Harbour Pointe Blvd Sw, Mukilteo, WA 98275-5457 | 2007-11-30 |
| 1225111867 | Darrell Eugene Cline | Dentist | 4112 Harbour Pointe Blvd Sw, Suite 200, Mukilteo, WA 98275 | 2006-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477030245 | Brandon Eugene Moore | Social Worker | 12303 Cyrus Way, Suite 107, Mukilteo, WA 98275 | 2018-07-25 |
| 1407349962 | Cascade Endocrinology Pllc | Internal Medicine | 8423 Mukilteo Spdwy Ste 102, Mukilteo, WA 98275 | 2018-06-10 |
| 1780059899 | Jamie Kowatch | Dietitian, Registered | 8423 Mukilteo Speedway Ste 102, Mukilteo, WA 98275 | 2015-12-01 |
| 1225479025 | Helen Ra | Pharmacist | 5600 Harbour Pointe Blvd., Unit 1-105, Mukilteo, WA 98275 | 2013-07-10 |
| 1861731333 | Lynn Sharon Schmidt | Physical Therapist | 10520 Harbour Pointe Blvd, Columbia Elementary School - Msd #6, Mukilteo, WA 98275 | 2013-02-04 |
| 1023318326 | Hillary E Hofstaedter | Registered Nurse | 10710 Mukilteo Speedway # 67, Mukilteo, WA 98275 | 2010-11-02 |
| 1528371416 | Zita Molnar Fekete | Counselor | 4460 73rd Pl Sw, Mukilteo, WA 98275 | 2010-07-20 |
| 1497900609 | Heidi S. Rendall | Family Medicine | 8227 44th Ave W., Ste E, Mukilteo, WA 98275 | 2008-12-02 |
| 1558583609 | Ana B Rountree | Physician Assistant | 10710 Mukilteo Spdwy, Mukilteo, WA 98275 | 2007-05-02 |
| 1376769752 | Wahid Elbahr | Dentist | 12121 Harbour Reach Dr., Ste 210, Mukilteo, WA 98275 | 2007-04-17 |
| Find all providers in zip 98275 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497900609 | Heidi S. Rendall | Family Medicine | 8227 44th Ave W., Ste E, Mukilteo, WA 98275 | 2008-12-02 |
| 1629150743 | Roger B. Olsson | Family Medicine | 11601 Harbour Pointe B Lvd, Suite 200, Mukilteo, WA 98275-5566 | 2006-10-19 |
| 1922037092 | Anchor Medical Clinic | Family Medicine | 8227 44th Ave West, Suite E, Mukilteo, WA 98275 | 2006-07-01 |
| 1760474738 | Chiyang Wu | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2005-08-16 |
| 1649702754 | Jason Hao | Family Medicine | 4410 106th St Sw, Mukilteo, WA 98275-4700 | 2017-03-28 |
| 1982912978 | Robert Arthur Anderson | Family Medicine | 610 5th St, Mukilteo, WA 98275-1504 | 2010-09-23 |
| 1639481500 | Dean Nair | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2010-07-08 |
| 1457684169 | Laura Renee Sobieck | Family Medicine | 4410 106th St Sw, Mukilteo, WA 98275-4700 | 2009-09-13 |
| 1720217011 | Sean H.s. Yang | Family Medicine | 4410 106th St Sw, Mukilteo, WA 98275-4700 | 2009-07-07 |
| 1669616363 | Providence Health & Services - Wa | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2009-04-24 |
| Find all providers in MUKILTEO | ||||
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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.