PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1295041028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295041028 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Other Organization Name | PROVIDENCE FAMILY MEDICINE |
| Practice Address |
212 E Central Ave Ste 440 Spokane WA 99208-6290 |
| Mailing Address |
Po Box 34439 Seattle WA 98124-1439 |
| Practice Telephone | 5094879602 |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2010-08-31 |
| Authorized Official Name | KEVIN WALSTROM (CFO) |
| Authorized Official Telephone | 5094822367 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Family Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740566173 | Providence Physician Services Co | Internal Medicine | 212 Central Ave Suite 440, Spokane, WA 99208 | 2011-10-31 |
| 1295016145 | Providence Physician Services Co | Family Medicine | 801 W. 5th Ave, Suite 307, Spokane, WA 99204 | 2011-09-06 |
| 1619268281 | Providence Physician Services Co | Family Medicine | 100 W. South Ave Chewelah, Chewelah, WA 99109 | 2011-04-29 |
| 1184915829 | Providence Physician Services Co | Family Medicine | 5011 W. Lowell Ave, Seattle, WA 99208-8587 | 2011-04-28 |
| 1578869913 | Providence Physician Services Co | Family Medicine | 12704 E Nora Ave, Ste B, Spokane Valley, WA 99216-1140 | 2011-02-02 |
| 1891001277 | Providence Physician Services Co | Pediatrics | 5901 N Linderwood, Suite 126, Spokane, WA 99207 | 2010-08-24 |
| 1245557917 | Providence Physician Services Co | Obstetrics & Gynecology | 518 Clay Street, Chewelah, WA 99109 | 2010-04-21 |
| 1215223953 | Providence Physician Services Co | Prosthetic/Orthotic Supplier | 101 W 8th Ave, Mother Gamelin Center, 3rd Floor, Spokane, WA 99204-2307 | 2011-06-21 |
| 1336433812 | Providence Physician Services Co | Family Medicine | 104 W 5th Ave, Suite 390e, Spokane, WA 99204 | 2011-06-02 |
| 1053618892 | Providence Physician Services Co | Internal Medicine | 105 W 8th Ave, Ste 550e, Spokane, WA 99204-2302 | 2011-02-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE PHYSICIAN SERVICES CO. | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Street Address |
212 E CENTRAL AVE STE 440 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-6290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891767190 | Julia S Doyle | Nurse Practitioner | 212 E Central Ave Ste 440, Spokane, WA 99208-6290 | 2006-02-02 |
| 1780141440 | Jennifer Wilson Maston | Nurse Practitioner | 212 E Central Ave Ste 440, Spokane, WA 99208-6290 | 2019-02-28 |
| 1669947818 | Caitlin Anne Snider | Dietitian, Registered | 212 E Central Ave Ste 440, Spokane, WA 99208-6290 | 2018-10-03 |
| 1023495512 | Ryan Massoud | Family Medicine | 212 E Central Ave Ste 440, Spokane, WA 99208 | 2015-05-04 |
| 1104213743 | Steven Klopsch | Family Medicine | 212 E Central Ave Ste 440, Spokane, WA 99208 | 2015-04-21 |
| 1740600550 | Hela Marie Kelsch | Family Medicine | 212 E Central Ave Ste 440, Spokane, WA 99208-6290 | 2014-04-18 |
| 1821418815 | Katheryn D. Hudon | Pediatrics | 212 E Central Ave Ste 440, Spokane, WA 99208-6290 | 2014-04-17 |
| 1366862369 | David Travis Hudon | Family Medicine | 212 E Central Ave Ste 440, Spokane, WA 99208-6290 | 2014-04-17 |
| 1699066613 | Ashish Sharma | Internal Medicine | 212 E Central Ave Ste 440, Spokane, WA 99208-6290 | 2011-04-25 |
| 1588734347 | William R. Brown | Family Medicine | 212 E Central Ave Ste 440, Spokane, WA 99208-6290 | 2006-11-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787161 | Bonnie Rose Spencer | Social Worker | E 44 Cozza, Spokane, WA 99208 | 2018-10-26 |
| 1235617515 | Melissa Dawn Scholl | Massage Therapist | 906 E Country Hill Ct, Spokane, WA 99208 | 2018-07-30 |
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1467943720 | Simone Ferguson | Student in an Organized Health Care Education/Training Program | 7808 North Morton Avenue, Apt. # 675, Spokane, WA 99208 | 2018-05-22 |
| 1912496035 | Ascend Network Corp | Counselor | 3711 W Woodside, Spokane, WA 99208 | 2018-05-03 |
| 1023522216 | Cherrywood Place-spokane, LLC | Assisted Living Facility | 100 East Dalke Ave, Spokane, WA 99208 | 2017-11-27 |
| 1881118792 | Annie Kamau | Registered Nurse | 5920 W Lonewolf, Spokane, WA 99208 | 2017-08-01 |
| 1609303908 | Jeffery Anthony Glinski | Counselor | 3754 W. Indian Trail Rd., Spokane, WA 99208 | 2017-05-17 |
| 1487186938 | Mukhlis Azar | Physical Therapy Assistant | 305 E Sierra Ct, Spokane, WA 99208 | 2017-04-03 |
| 1154796241 | Daisy O'dell | Marriage & Family Therapist | 515 W. Francis Ave., Suite #8, Spokane, WA 99208 | 2015-12-01 |
| Find all providers in zip 99208 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1740690049 | Ashley Claire Mccorkhill | Pediatrics | 1514 S Tacoma St, Spokane, WA 99203-2260 | 2014-05-07 |
| 1891001277 | Providence Physician Services Co | Pediatrics | 5901 N Linderwood, Suite 126, Spokane, WA 99207 | 2010-08-24 |
| 1568591923 | Bridget Z Duffy | Pediatrics | 1111 E Westview Ct Ste B, Spokane, WA 99218-1376 | 2007-03-03 |
| 1831296177 | Deborah Ann Icenogle | Pediatrics | 5011 W Lowell Ave Ste 100, Spokane, WA 99208-8587 | 2006-09-20 |
| 1417061169 | Joseph B Mcmanus | Pediatrics | 5901 N Lidgerwood, Suite 220, Spokane, WA 99208 | 2006-08-19 |
| 1962494393 | David R Fregeau | Pediatrics | 101 W Eighth, Spokane, WA 99220-2555 | 2005-08-22 |
| 1932680949 | Spokane Pediatrics Pllc | Pediatrics | 315 W 9th Ave Ste 200, Spokane, WA 99204 | 2018-08-27 |
| 1396253910 | Grand Pediatrics, P.s. | Pediatrics | 1402 S Grand Blvd, Spokane, WA 99203-5001 | 2018-01-17 |
| 1275053514 | Angela Denise Beauchamp | Pediatrics | 1402 S Grand Blvd, Spokane, WA 99203-5001 | 2017-06-27 |
| Find all providers in SPOKANE | ||||
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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.