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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Providence Cardiology Associates | Doing Business As Name - Organization |
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 |
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 |
500 LILLY RD NE SUITE 100 |
City | OLYMPIA |
State | WA |
Zip Code | 98506-5195 |
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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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 |
Find all providers in zip 98506 |
Taxonomy Code | 207RC0000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Cardiovascular Disease |
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. |
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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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.