PROVIDENCE HEALTH & SERVICES-WASHINGTON


Address: 500 Lilly Rd Ne, Suite 100, Olympia, WA 98506-5195
Phone: 3604138525

PROVIDENCE HEALTH & SERVICES-WASHINGTON (NPI# 1164724308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164724308
Entity Type Organization
Organization Name PROVIDENCE HEALTH & SERVICES-WASHINGTON
Other Organization Name PROVIDENCE CARDIOLOGY ASSOCIATES
Practice Address 500 Lilly Rd Ne
Suite 100
Olympia
WA 98506-5195
Practice Telephone 3604138525
Practice Fax Number 3604138800
Mailing Telephone 3604138525
Mailing Fax Number 3604138800
Enumeration Date 2010-11-20
Last Update Date 2010-11-20
Authorized Official Name MS. WILLA NIZOLEK (OFFICE MANAGER)
Authorized Official Telephone 3604138525
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Providence Cardiology Associates Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1679763668 Providence Health & Services-washington General Acute Care Hospital 101 W 8th Ave, Spokane, WA 99204-2307 2007-07-26
1952323859 Providence Health & Services-washington Alzheimer Center (Dementia Center) 3760 Piper St, Suite 1061, Anchorage, AK 99508-4683 2006-07-23

Other Data Sources

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

Office Location

Street Address 500 LILLY RD NE
SUITE 100
City OLYMPIA
State WA
Zip Code 98506-5195

Providers in the same location

NPI Name Taxonomy Address Enumeration
1871594325 David H Schoening Internal Medicine 500 Lilly Rd Ne, Ste 100, Olympia, WA 98506 2005-08-09
1720644073 Carol Neff Moreno Family Medicine 500 Lilly Rd Ne, Olympia, WA 98506-5195 2019-05-13
1770936015 Ester Monique Brown Licensed Practical Nurse 500 Lilly Rd Ne, Olympia, WA 98506-5195 2016-07-22
1073969101 Samantha Moore Physician Assistant 500 Lilly Rd Ne, Olympia, WA 98506-5195 2016-05-07
1467720292 Sarah Byram Poppe Nurse Practitioner 500 Lilly Rd Ne, Suite 204, Olympia, WA 98506-5197 2011-12-07
1659554624 Scott David Werden Internal Medicine 500 Lilly Rd Ne, Memorial Medical Plaza, Olympia, WA 98506-5195 2007-12-12
1124144431 Elijah Telfare Physician Assistant 500 Lilly Rd Ne, Suite 100, Olympia, WA 98506-5195 2007-03-21
1194867887 Northwest Radiology Group LLC Specialist 500 Lilly Rd Ne, Suite 160, Olympia, WA 98506-5195 2007-02-12
1245391390 Patrick C Williams Physician Assistant 500 Lilly Rd Ne, Suite 204, Olympia, WA 98506-5197 2006-12-13
1356446777 Theodore Martin Johnson Psychologist 500 Lilly Rd Ne, #205, Olympia, WA 98506-5195 2006-09-13
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861446494 Qiang Li Internal Medicine 500 Lilly Rd Ne Ste 100, Olympia, WA 98506-5195 2006-05-19
1871594325 David H Schoening Internal Medicine 500 Lilly Rd Ne, Ste 100, Olympia, WA 98506 2005-08-09
1740281294 Christopher L Wolfe Internal Medicine 406a Black Hills Ln Sw, Olympia, WA 98502 2005-08-09
1437157674 Michael J Menen Internal Medicine 413 Lilly Rd Ne, Olympia, WA 98506-5133 2005-07-12
1336456672 Natasha P Arora Internal Medicine 500 Lilly Rd Ne Ste 100, Providence Cardiology Associates, Olympia, WA 98506-5195 2010-09-08
1679884993 Matthew S Berger Internal Medicine 406-a Black Hills Ln Sw, Olympia, WA 98502 2010-07-01
1669797320 Charles Frederick Rossow Internal Medicine 500 Lilly Rd Ne Ste 100, Olympia, WA 98506-5195 2010-04-06
1750543906 Sara Cecilia Martinez Internal Medicine 500 Lilly Rd Ne Ste 100, Providence Cardiology Associates, Olympia, WA 98506-5195 2008-06-30
1659554624 Scott David Werden Internal Medicine 500 Lilly Rd Ne, Memorial Medical Plaza, Olympia, WA 98506-5195 2007-12-12
1902962707 Cardiology Associates Pllc Internal Medicine 500 Lilly Rd Ne Ste 100, Olympia, WA 98506-5195 2006-12-28
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Competitor

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City OLYMPIA
Zip Code 98506

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Dataset Information

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.

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