PROVIDENCE HEALTH & SERVICES-WA (NPI# 1306097415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306097415 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES-WA |
| Practice Address |
916 Pacific Ave 1 South Everett WA 98201-4147 |
| Mailing Address |
Po Box 3369 Portland OR 97208-3369 |
| Practice Telephone | 4252587390 |
| Practice Fax Number | 4252587379 |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2018-01-11 |
| Authorized Official Name | DONALD WAYNE ANDERSON JR. (ASST SECRETARY-ENROLLMENT) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114236791 | Providence Health & Services-wa | Surgery | 1330 Rockefeller Avenue, Suite 400, Everett, WA 98201-1676 | 2010-09-30 |
| 1588294854 | Providence Health & Services-wa | Clinic/Center | 916 Pacific Ave, Everett, WA 98201-4147 | 2020-01-24 |
| 1649615220 | Providence Health & Services-wa | Naturopath | 1321 Colby Ave, Everett, WA 98201-1665 | 2013-05-08 |
| 1215225099 | Providence Health & Services-wa | Midwife | 14692 179th Ave Se, Ste 800, Monroe, WA 98272-1162 | 2011-07-14 |
| 1447547658 | Providence Health & Services-wa | Registered Nurse | 14692 179th Ave Se, Ste 800, Monroe, WA 98272-1162 | 2011-07-08 |
| 1891088845 | Providence Health & Services-wa | Pharmacy | 3305 Nassau St # 101, Everett, WA 98201-4140 | 2011-05-24 |
| 1831499755 | Providence Health & Services-wa | Orthopaedic Surgery | 1330 Rockefeller Ave, Suite 225, Everett, WA 98201-1684 | 2010-10-26 |
| 1972819175 | Providence Health & Services-wa | Registered Nurse | 3305 Nassau St, Everett, WA 98201-4140 | 2010-08-25 |
| 1164747242 | Providence Health & Services-wa | General Practice | 1717 13th Street, Everett, WA 98201-1621 | 2010-04-01 |
| 1346571841 | Providence Health & Services-wa | Nurse Practitioner | 1330 Rockefeller, Suite 200, Everett, WA 98201-1677 | 2010-01-22 |
| 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 |
916 PACIFIC AVE 1 SOUTH |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-4147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245203587 | Elizabeth Gearou | Physical Therapist | 916 Pacific Ave, Everett, WA 98201-4147 | 2006-02-08 |
| 1588294854 | Providence Health & Services-wa | Clinic/Center | 916 Pacific Ave, Everett, WA 98201-4147 | 2020-01-24 |
| 1083264873 | Olivia Bromley | Speech-Language Pathologist | 916 Pacific Ave, Everett, WA 98201-4147 | 2019-09-13 |
| 1235783952 | Katie Anacker | Physical Therapy Assistant | 916 Pacific Ave, Everett, WA 98201-4147 | 2019-07-31 |
| 1891348488 | Judith Kelly | Physical Therapist | 916 Pacific Ave, Everett, WA 98201-4147 | 2019-07-23 |
| 1669025185 | William Michael Crenshaw | Occupational Therapy Assistant | 916 Pacific Ave, Everett, WA 98201-4147 | 2019-07-23 |
| 1053963751 | Bethany Smith Gopalakrishnan | Physical Therapist | 916 Pacific Ave, Everett, WA 98201-4147 | 2019-07-12 |
| 1245891241 | Rebecca Christine Aronsen | Dietitian, Registered | 916 Pacific Ave, Everett, WA 98201-4147 | 2019-06-21 |
| 1679084719 | Emily Charoenset | Occupational Therapy Assistant | 916 Pacific Ave, Everett, WA 98201-4147 | 2017-10-16 |
| 1720505613 | Anica Rae Faucett | Occupational Therapy Assistant | 916 Pacific Ave, Everett, WA 98201-4147 | 2017-08-23 |
| Find all providers in the same location | ||||
| 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 | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609326511 | Ideal Option, Pllc | Family Medicine | 3624 Colby Ave, Ste B, Everett, WA 98201-4776 | 2016-10-04 |
| 1588708176 | Steven K Burrows | Family Medicine | 2930 Maple St, Everett, WA 98201-3832 | 2007-02-16 |
| 1609968304 | William E. Dickinson | Family Medicine | 916 Pacific Ave, First Floor, Everett, WA 98201-4147 | 2006-09-29 |
| 1477645133 | Rohinton K. Merchant | Family Medicine | 916 Pacific Ave, 1 South, Everett, WA 98201-4147 | 2006-09-29 |
| 1215990643 | Todd S Carran | Family Medicine | 916 Pacific Ave, Everett, WA 98201-4147 | 2006-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194342162 | Bicycle Health Medical Group Pa | Family Medicine | 1700 Westlake Ave N Ste 200, Seattle, WA 98109-6212 | 2020-06-25 |
| 1134748643 | Workit Health Mi Pllc | Family Medicine | 4505 Pacific Hwy E Ste C2, Fife, WA 98424-2638 | 2020-04-14 |
| 1508322363 | Heal From Addiction, LLC | Family Medicine | 7 S Howard St Ste 210, Spokane, WA 99201-3816 | 2019-02-18 |
| 1366953630 | Ideal Option, Pllc | Family Medicine | 8921 E Alki Ave Ste 1, Spokane Valley, WA 99212-2705 | 2017-10-13 |
| 1962928200 | E & H Holdings, LLC | Family Medicine | 708 E Penn St, Moses Lake, WA 98837 | 2017-08-18 |
| 1851816409 | Ideal Option, Pllc | Family Medicine | 406 Se 131st Ave Ste 104, Vancouver, WA 98683-4031 | 2017-08-04 |
| 1467903054 | Ideal Option, Pllc | Family Medicine | 1725 Continental Pl, Ste C, Mount Vernon, WA 98273-5693 | 2016-10-18 |
| 1912395211 | Consistent Care Services Spc, Ps | Family Medicine | 1612 4th St, Suite 200, Marysville, WA 98270-5045 | 2015-01-08 |
| 1558685925 | Central Washington Sleep Diagnostic Center, Pllc | Family Medicine | 2323 W Broadway Ave Ste 4, Moses Lake, WA 98837 | 2010-03-15 |
| 1497081855 | Jsn Inc | Family Medicine | 1135 Ellis St, Bellingham, WA 98225-5246 | 2009-10-20 |
| 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.