PROVIDENCE HEALTH & SERVICES - WA (NPI# 1225335425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225335425 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WA |
| Other Organization Name | PMG NW WA EVER VASCULAR SURG |
| Practice Address |
1330 Rockefeller Ave Ste 520 Everett WA 98201-1684 |
| Mailing Address |
Po Box 3360 Portland OR 97208-3360 |
| Practice Telephone | 4252875200 |
| Practice Fax Number | 4252875210 |
| Mailing Telephone | 8663662983 |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2015-06-11 |
| Authorized Official Name | PAULA WOOD (PROVIDER CONCIERGE COORDINATOR) |
| Authorized Official Telephone | 4252614082 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PMG NW WA Ever Vascular Surg | 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 |
| 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 |
| 1003050709 | Providence Health & Services - Wa | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite100, 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 |
1330 ROCKEFELLER AVE STE 520 |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-1684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366435943 | John F Matista | Physician Assistant | 1330 Rockefeller Ave, Suite 225, Everett, WA 98201-1684 | 2005-08-29 |
| 1326598715 | Providence Regional Medical Center | Clinic/Center | 1330 Rockefeller Ave, Suite 150 Medical Offfic Building, Everett, WA 98201-1684 | 2016-10-10 |
| 1861940504 | Lindsay Cook Mertz | Physician Assistant | 1330 Rockefeller Ave, Suite 310, Everett, WA 98201-1684 | 2016-09-12 |
| 1437524352 | John Gavareski | Physician Assistant | 1330 Rockefeller Ave, Everett, WA 98201-1684 | 2015-12-03 |
| 1700261120 | Anna Chan | Pharmacist | 1330 Rockefeller Ave, Suite 150, Everett, WA 98201-1684 | 2015-07-27 |
| 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 |
| 1538554761 | Patrick M Haugstad | Pharmacist | 1330 Rockefeller Ave, Suite 150, Everett, WA 98201-1684 | 2015-04-03 |
| 1770972481 | Lisa Mccabe | Nurse Practitioner | 1330 Rockefeller Ave, Suite 310, Everett, WA 98201-1684 | 2015-01-19 |
| 1851798714 | Emily Rockwell Williamson | Pharmacist | 1330 Rockefeller Ave, Suite 150, Everett, WA 98201 | 2014-11-20 |
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| 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 | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 |
|---|---|---|---|---|
| 1497975361 | Rolando I Celis Valdiviezo | Surgery | 1330 Rockefeller Ave Ste 520, Everett, WA 98201 | 2007-04-26 |
| 1396894879 | Anthony J. Roon | Surgery | 1001 N Broadway Ste A3, Everett, WA 98201-1585 | 2007-01-10 |
| 1457338451 | Philip D. Feliciano | Surgery | 1321 Colby Avenue, Providence Everett Medical Center, Everett, WA 98206 | 2005-12-30 |
| 1184664625 | David E Mullane | Surgery | 512 Broadway, Suite 2, Everett, MA 02149-3738 | 2006-06-06 |
| 1720066616 | William Burley Mcintyre | Surgery | 1321 Colby Ave, Providence Everett Medical Center, Everett, WA 98201-1665 | 2006-01-03 |
| 1649257692 | Robert D. Defrang | Surgery | 1330 Rockefeller Ave, Ste 520, Everett, WA 98201-1684 | 2005-12-29 |
| 1255318317 | James M. Cook Jr. | Surgery | 1330 Rockefeller Ave, Ste 520, Everett, WA 98201-1684 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496922 | Sunnyside Community Hospital Association | Surgery | 1005 W Walnut St Ste 201, Yakima, WA 98902-3384 | 2017-09-20 |
| 1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
| 1356722938 | Usa Vascular Centers of Kent Pllc | Surgery | 26124a Pacific Hwy S Ste A, Kent, WA 98032-6910 | 2015-06-09 |
| 1154602084 | Memorial Physicians, Pllc | Surgery | 1812 E Edison Ave, Sunnyside, WA 98944-1653 | 2011-09-06 |
| 1528387941 | Sara Jane Wasilenko | Surgery | 128 Lilly Rd Ne Ste 205, Olympia, WA 98506-7400 | 2010-05-25 |
| 1801051404 | Franciscan Medical Group | Surgery | 710 S 348th St, Ste A, Federal Way, WA 98003-7042 | 2008-07-23 |
| 1013104165 | John S Arthur | Surgery | 2528 Wheaton Way Ste 101, Bremerton, WA 98310-3305 | 2007-10-02 |
| 1891986097 | Vascular Associates, Ps | Surgery | 801 Broadway Ste 522, Seattle, WA 98122-4325 | 2007-08-05 |
| 1447464730 | Mai Thanh Pham | Surgery | 1229 Madison St Suite # 1190, Seattle, WA 98104 | 2007-05-09 |
| 1649491481 | Dae Young Lee | Surgery | 1100 Goethals Drive 3rd Floor, Kadlec Clinic Vascular Surgery, Richland, WA 99352-3304 | 2007-05-01 |
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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.