PROVIDENCE EVERETT MEDICAL CENTER (NPI# 1316041056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316041056 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE EVERETT MEDICAL CENTER |
| Practice Address |
1321 Colby Ave Everett WA 98201-1665 |
| Mailing Address |
909 N Broadway Pbo Credentialing Everett WA 98201-1409 |
| Practice Telephone | 4252612000 |
| Practice Fax Number | 4252614051 |
| Mailing Telephone | 4253170699 |
| Mailing Fax Number | 4252614051 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2008-09-22 |
| Authorized Official Name | MRS. JOYCE KOBAYASHI (DIR REVENUE CYCLE MGMT NWSA) |
| Authorized Official Telephone | 4253170186 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | H-084 | WA | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 3309606 | 05 | |
| WA | HOSPITAL'S LICENSE # | H-084 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073773198 | Providence Everett Medical Center | Clinic/Center | 4112 Harbour Pointe Blvd, Suite 100, Mukilteo, WA 98275-4700 | 2008-06-12 |
| 1982805784 | Providence Everett Medical Center | Social Worker | 900 Pacific Ave, First Floor, Everett, WA 98201-4168 | 2007-05-30 |
| 1538377957 | Providence Everett Medical Center | Clinical Medical Laboratory | 1321 Colby Ave, Everett, WA 98201-1665 | 2007-05-18 |
| 1063551596 | Providence Everett Medical Center | Clinic/Center | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2007-02-05 |
| 1740344100 | Providence Everett Medical Center | Nutritionist | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2006-12-20 |
| 1255495024 | Providence Everett Medical Center | Nutritionist | 900 Pacific Ave, First Floor, Everett, WA 98201-4168 | 2006-12-19 |
| 1770643629 | Providence Everett Medical Center | Nurse Practitioner | 916 Pacific Ave, 1 South, Everett, WA 98201-4147 | 2006-12-11 |
| 1104993716 | Providence Everett Medical Center | Nurse Practitioner | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2006-11-29 |
| 1447326574 | Providence Everett Medical Center | Clinic/Center | 900 Pacific Ave, Suite 200, Everett, WA 98201-4168 | 2006-11-28 |
| 1992871735 | Providence Everett Medical Center | Clinic/Center | 1001 N Broadway, Suite A-3, Everett, WA 98201-1586 | 2006-11-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE EVERETT MEDICAL CENTER | 1321 Colby Ave, Everett, WA 98206 |
| Street Address |
1321 COLBY AVE |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-1665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073519328 | Albert Dominick Pacifico II | Internal Medicine | 1321 Colby Ave, Medical Staff Office, Everett, WA 98201-1665 | 2005-06-22 |
| 1083239610 | Arianna Randolph | Social Worker | 1321 Colby Ave, Everett, WA 98201-1665 | 2020-06-09 |
| 1619527595 | Katherine Doreen Carpenter | Pharmacy Technician | 1321 Colby Ave, C-wing First Floor, Everett, WA 98201 | 2019-09-12 |
| 1396302477 | Ashley L Grieve | Nurse Practitioner | 1321 Colby Ave, Everett, WA 98201-1665 | 2019-05-23 |
| 1588140073 | Naa Afadua Annoh | Nurse Practitioner | 1321 Colby Ave, Everett, WA 98201-1665 | 2018-07-17 |
| 1386170694 | Katherine Mccusker | Nurse Practitioner | 1321 Colby Ave, Everett, WA 98201-1665 | 2017-05-05 |
| 1437602935 | Rebecca Louise Formosa | Nurse Practitioner | 1321 Colby Ave, Everett, WA 98201-1665 | 2016-08-01 |
| 1144673153 | Julie Editha Quandt | Nurse Practitioner | 1321 Colby Ave, Everett, WA 98201-1665 | 2016-07-14 |
| 1013361518 | Rhadika Mccormick Souza | Emergency Medicine | 1321 Colby Ave, Everett, WA 98201-1665 | 2016-04-20 |
| 1013379114 | Katherine Morgan | Internal Medicine | 1321 Colby Ave, Everett, WA 98201-1665 | 2016-03-28 |
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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 |
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| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861886509 | Whidden Memorial Hospital | General Acute Care Hospital | 103 Garland St, Everett, MA 02149-5066 | 2015-03-19 |
| 1104197946 | Joanne White | General Acute Care Hospital | 103 Garland Street, Whidden Hospital, Everett, MA 02149 | 2012-01-25 |
| 1427346113 | Providence Regional Medical Center Everett | General Acute Care Hospital | 1321 Colby Ave, Everett, WA 98201-1665 | 2011-07-14 |
| 1700037801 | Providence Health & Services-wa | General Acute Care Hospital | 1321 Colby Ave, Everett, WA 98201-1665 | 2008-10-07 |
| 1124207915 | Cambridge Health Alliance | General Acute Care Hospital | 103 Garland St, Everett, MA 02149-5066 | 2007-10-29 |
| 1447446380 | Cambridge Health Alliance | General Acute Care Hospital | 103 Garland St, Everett, MA 02149-5066 | 2007-09-24 |
| 1619160108 | Cambridge Health Alliance | General Acute Care Hospital | 103 Garland St, Everett, MA 02149-5066 | 2007-08-20 |
| 1194918680 | Cambridge Health Alliance | General Acute Care Hospital | 103 Garland St, Everett, MA 02149-5066 | 2007-08-20 |
| 1134311145 | Cambridge Health Alliance | General Acute Care Hospital | 103 Garland St, Everett, MA 02149-5066 | 2007-08-14 |
| 1407976152 | Upmc Bedford | General Acute Care Hospital | 195 Memorial Dr, Suite 3, Everett, PA 15537-7056 | 2007-03-29 |
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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.