PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1174814552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174814552 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Other Organization Name | POPLAR MEDICAL COMPLEX DME |
| Practice Address |
301 W Poplar St Walla Walla WA 99362-2858 |
| Mailing Address |
Po Box 34439 Seattle WA 98124-1439 |
| Practice Telephone | 5095263333 |
| Mailing Telephone | 4255256650 |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2011-04-20 |
| Authorized Official Name | DANIEL T HARRIS (CFO) |
| Authorized Official Telephone | 4256873603 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Other Name | Type Code |
|---|---|
| Poplar Medical Complex DME | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407162571 | Providence Health & Services - Washington | Internal Medicine | 510 E Amende Drive, Odessa, WA 99159-0000 | 2010-08-26 |
| 1841503034 | Providence Health & Services - Washington | Family Medicine | 18313 Paulsonst Sw, Suite A, Rochester, WA 98579-9262 | 2010-07-16 |
| 1083947709 | Providence Health & Services - Washington | Hospice Care, Community Based | 2731 Wetmore Ave Ste 500, Everett, WA 98201-3585 | 2009-09-14 |
| 1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
| 1558512368 | Providence Health & Services - Washington | Home Health | 209 W Poplar St, Walla Walla, WA 99362 | 2008-10-10 |
| 1922259738 | Providence Health & Services - Washington | Internal Medicine | 380 Chase Avenue, Pmg Se Wa, Walla Walla, WA 99362-2924 | 2008-10-10 |
| 1306097126 | Providence Health & Services - Washington | Radiology | 401 W Poplar Street, Pmg Se Wa Imaging, Walla Walla, WA 99362-2846 | 2008-10-10 |
| 1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
| 1073677605 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 506 W Franklin St, Shelton, WA 98584-3517 | 2006-12-20 |
| 1003906918 | Providence Health & Services - Washington | Home Health | 3432 Bay Rd Ne, Olympia, WA 98506-2958 | 2006-10-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
301 W POPLAR ST |
| City | WALLA WALLA |
| State | WA |
| Zip Code | 99362-2858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164427456 | Guy Frank Gehling | Neurological Surgery | 301 W Poplar St, Ste 220, Walla Walla, WA 99362-2858 | 2005-06-14 |
| 1497254635 | Corey Carson | Physician Assistant | 301 W Poplar St, Walla Walla, WA 99362-2858 | 2018-02-02 |
| 1699000901 | Chelane R Fackenthall | Registered Nurse | 301 W Poplar St, Suite 100, Walla Walla, WA 99362-2858 | 2009-10-05 |
| 1417191057 | Providence Health & Services - Washington | Urology | 301 W Poplar St, Suite 50, Walla Walla, WA 99362-2858 | 2009-04-27 |
| 1326282963 | Providence Health & Services - Washington | Otolaryngology | 301 W Poplar St, Suite 210, Walla Walla, WA 99362-2858 | 2009-04-27 |
| 1235373879 | Providence Health & Services - Washington | Internal Medicine | 301 W Poplar St, Suite 100, Walla Walla, WA 99362-2858 | 2009-04-27 |
| 1811130156 | Providence Health & Services - Washington | Surgery | 301 W Poplar St, Suites 50, Walla Walla, WA 99362-2858 | 2009-04-16 |
| 1104070598 | Brianne Nicole Bridgeland | Registered Nurse | 301 W Poplar St, Suite #210, Walla Walla, WA 99362-2858 | 2008-11-11 |
| 1417165382 | Jennifer W Leach | Internal Medicine | 301 W Poplar St, Suite 100, Walla Walla, WA 99362-2858 | 2007-05-21 |
| 1194949594 | Jason Adam Dreyer | Neurological Surgery | 301 W Poplar St, Walla Walla, WA 99362-2858 | 2007-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164065959 | Kevin Gia-minh Phan | Optometrist | Walla Walla Vamc Bldg 86, Walla Walla, WA 99362 | 2019-10-24 |
| 1659836401 | Arlene Lavonne Whitney | Social Worker | 1361 Dalles Military Road, Walla Walla, WA 99362 | 2019-02-06 |
| 1053880674 | Julie Ann Cooke | Speech-Language Pathologist | Providence St. Mary Medical Center, 401 W. Poplar St., Walla Walla, WA 99362 | 2018-11-14 |
| 1558887133 | Chantey Walker | Massage Therapist | 1840 Pleasant St, Walla Walla, WA 99362 | 2017-08-16 |
| 1447798723 | Carrie S Diede | Speech-Language Pathologist | 410 West Poplar Street, Rehabilitation Services, Walla Walla, WA 99362 | 2017-02-07 |
| 1235584103 | Anchor Point Counseling Pllc | Clinic/Center | 2330 Eastgate St. Ste. 140, Walla Walla, WA 99362 | 2016-04-28 |
| 1548627011 | Washington State Walla Walla Veterans Home | Skilled Nursing Facility | 92 Wainwright Drive, Walla Walla, WA 99362 | 2016-01-28 |
| 1073926200 | Sherry Goff | Registered Nurse | 11120 W Rose St, Family Medical Center, Walla Walla, WA 99362 | 2014-06-05 |
| 1538597935 | Michael Wade Gillespie | Orthopaedic Surgery | 101 Brookside Drive, Walla Walla, WA 99362 | 2013-10-22 |
| 1023357985 | Sandra Kay Bushnell | Speech-Language Pathologist | 1105 Isaacs Ave, Walla Walla, WA 99362 | 2013-02-12 |
| Find all providers in zip 99362 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679636963 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 489 N Wilbur Ave, Walla Walla, WA 99362-2253 | 2006-12-18 |
| 1407949068 | Walgreen Co. | Durable Medical Equipment & Medical Supplies | 633 W Tietan St, Walla Walla, WA 99362-4329 | 2006-10-02 |
| 1932218245 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 2028 East Isaacs Avenue, Walla Walla, WA 99362-2214 | 2006-08-30 |
| 1417980772 | Bimart Corporation | Durable Medical Equipment & Medical Supplies | 1649 Plaza Way, Walla Walla, WA 99362-4324 | 2006-07-09 |
| 1518993393 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 1600 Plaza Way, Walla Walla, WA 99362-4325 | 2006-06-24 |
| 1831135441 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 215 E Rose St, Walla Walla, WA 99362-1216 | 2006-06-21 |
| 1144260571 | Shopko Stores Operating Co LLC | Durable Medical Equipment & Medical Supplies | 1651 W Rose St, Walla Walla, WA 99362-1771 | 2006-06-07 |
| 1710978564 | Db Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 1365 Dalles Military Rd, Walla Walla, WA 99362-4300 | 2005-11-01 |
| 1942203781 | Walla Walla Homemedical Inc | Durable Medical Equipment & Medical Supplies | 329 S 2nd Ave, Walla Walla, WA 99362-3034 | 2005-05-24 |
| 1306291133 | Albertsons LLC | Durable Medical Equipment & Medical Supplies | 450 N Wilbur Ave, Walla Walla, WA 99362-2254 | 2016-04-29 |
| Find all providers in WALLA WALLA | ||||
| City | WALLA WALLA |
| Zip Code | 99362 |
Please comment or provide details below to improve the information on PROVIDENCE HEALTH & SERVICES - WASHINGTON.
| 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.