PROVIDENCE HEALTH & SERVICES (NPI# 1255644027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255644027 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES |
| Other Organization Name | PROVIDENCE SPOKANE HEART INSTITUTE-CLEARWATER VALLEY HOSPITAL & CLINIC |
| Practice Address |
301 Cedar St Orofino ID 83544-9029 |
| Mailing Address |
Po Box 3776 Seattle WA 98124-3776 |
| Practice Telephone | 2084765777 |
| Mailing Telephone | 4255256798 |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2010-11-11 |
| Authorized Official Name | KAREN DUNCAN (SR. DIRECTOR OF REVENUE CYCLE MGT) |
| Authorized Official Telephone | 4252545362 |
| 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 Spokane Heart Institute-Clearwater Valley Hospital & Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609322528 | Providence Health & Services | In Home Supportive Care | 110 S. Third Street E., Chewelah, WA 99109 | 2016-08-31 |
| 1811201312 | Providence Health & Services | Internal Medicine | 715 S Washington, Suite A, Moscow, ID 83843-0000 | 2010-07-27 |
| 1720391659 | Providence Health & Services | Internal Medicine | 629 Jasmine St, Omak, WA 98841 | 2010-07-20 |
| 1114230042 | Providence Health & Services | Internal Medicine | 318 E Rowan Ave, 240, Spokane, WA 99207-1200 | 2010-07-20 |
| 1154539203 | Providence Health & Services | Internal Medicine | 1510 Division St Ste 200, Oregon City, OR 97045-1599 | 2007-05-21 |
| 1780742114 | Providence Health & Services | Internal Medicine | 1515 Portland Rd, Newberg, OR 97132-1844 | 2006-12-05 |
| 1831639731 | Providence Health & Services | Home Health Aide | 12800 Bothell Everett Hwy, Suite 290, Everett, WA 98208-6642 | 2017-02-27 |
| 1093056632 | Providence Health & Services | General Acute Care Hospital | 6801 Coldwater Canyon Ave, Suite 1a, North Hollywood, CA 91605-5162 | 2013-03-06 |
| 1689977159 | Providence Health & Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 700 W Ironwood Dr, Suite 350, Coeur D Alene, ID 83814-2656 | 2010-12-06 |
| 1245544584 | Providence Health & Services | Internal Medicine | 1550 S Pioneer Way, Pioneer Medical Center #250, Moses Lake, WA 98837-4613 | 2010-07-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - MONTANA | 1801 Lind Ave Sw, Renton, WA 98057 |
| Colorado Business Entities | Providence Health & Services - Montana | Dept of Legal Affairs, 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - MONTANA | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Colorado Business Entities | Providence Health & Services - Oregon | 1801 Lind Avenue, Sw, Renton, WA 98057-9016 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 4400 Ne Halsey St Bldg 2 Ste 690, Portland, OR 97213-1545 |
| Iowa Business Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
| Street Address |
301 CEDAR ST |
| City | OROFINO |
| State | ID |
| Zip Code | 83544-9029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659376010 | Peter W Crecelius | Family Medicine | 301 Cedar St, Orofino, ID 83544-9029 | 2005-06-14 |
| 1891308201 | Daniel Burton | Occupational Therapist | 301 Cedar St, Orofino, ID 83544-9029 | 2020-08-25 |
| 1598391492 | Luke Matzen | Physical Therapist | 301 Cedar St, Orofino, ID 83544-9029 | 2020-03-23 |
| 1750804209 | Rana Janine Cleary | Technician | 301 Cedar St, Orofino, ID 83544-9029 | 2017-07-17 |
| 1467901330 | Taresa Lynn Michna | Nurse Practitioner | 301 Cedar St, Orofino, ID 83544-9029 | 2016-10-03 |
| 1982073946 | Clearwater Valley Hospital and Clinics, Inc | General Acute Care Hospital | 301 Cedar St, Orofino, ID 83544-9029 | 2015-09-21 |
| 1285018754 | Orofino Health Center | Family Medicine | 301 Cedar St, Orofino, ID 83544-9029 | 2015-07-15 |
| 1922414408 | Tammy Jo Miller | Nurse Practitioner | 301 Cedar St, Orofino, ID 83544 | 2014-07-07 |
| 1982028437 | Rachell Larsen | Dietitian, Registered | 301 Cedar St, Orofino, ID 83544-9029 | 2014-02-04 |
| 1386078418 | Shelly D Theobald | Family Medicine | 301 Cedar St, Orofino, ID 83544-9029 | 2013-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598229809 | Clearwater Canyon Pharmacy, LLC | Pharmacy | 13020 Us-12, Orofino, ID 83544 | 2019-01-31 |
| 1295130698 | Brian Shapiro | Marriage & Family Therapist | 155 Main Street Stuite C, Orofino, ID 83544 | 2014-10-28 |
| 1942497052 | Jean M. Shropshire | Speech-Language Pathologist | 123 1st St., Orofino, ID 83544 | 2007-10-02 |
| 1417161969 | Jeffrey David Hartshorn | Chiropractor | 437 College Avenue, Orofino, ID 83544 | 2007-05-10 |
| 1598808099 | Orofino Physical Therapy and Wellness Inc | Physical Medicine & Rehabilitation | 1005 Michigan Ave, Orofino, ID 83544 | 2007-02-14 |
| 1083766356 | Adam C. Dayley, O.d., P.C. | Optometrist | 906 Michigan Ave., Orofino, ID 83544 | 2007-01-17 |
| 1710037882 | Douglas L Frank | Pharmacist | 1105 Michigan Avenue, Orofino, ID 83544 | 2007-01-11 |
| 1386718047 | Irene Lamberti | Chiropractor | 437 College Ave., Orofino, ID 83544 | 2006-11-17 |
| 1730281064 | Clearwater County | Ambulance | 1195 Riverside Avenue, Orofino, ID 83544 | 2006-09-05 |
| 1538101050 | Wendi Rene Richardson | Nurse Anesthetist, Certified Registered | 301 Cedar, Clearwater Valley Hospital, Orofino, ID 83544 | 2006-06-11 |
| Find all providers in zip 83544 | ||||
| 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 |
|---|---|---|---|---|
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1811201312 | Providence Health & Services | Internal Medicine | 715 S Washington, Suite A, Moscow, ID 83843-0000 | 2010-07-27 |
| 1730323080 | Wayne Wright | Internal Medicine | 2664 E 3700 N, Twin Falls, ID 83301-0145 | 2009-04-29 |
| 1184824617 | Michael D Kenner, Md,pc | Internal Medicine | 1721 S 10th Ave, Caldwell, ID 83605-4839 | 2007-07-23 |
| 1497807812 | Grande Ronde Hospital, Inc | Internal Medicine | 300 E Jefferson St Ste 101, Boise, ID 83712-6221 | 2007-01-17 |
| 1700983137 | Lee Walter Gould | Internal Medicine | 307 St. John's Way, Suite 114, Lewiston, ID 83501-2456 | 2006-09-20 |
| 1730285719 | Beth R Malasky | Internal Medicine | 6140 Curtisian, Ste 200, Boise, ID 83704-0107 | 2006-09-16 |
| 1730192329 | Cardiovascular Consultants of Idaho | Internal Medicine | 1070 N Curtis Rd, Ste 125, Boise, ID 83706-1238 | 2006-08-14 |
| 1477578300 | John E Lassetter | Internal Medicine | 2001 S Woodruff Ave Ste 3, Idaho Falls, ID 83404 | 2006-07-13 |
| Find all providers with the same taxonomy | ||||
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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.