PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1407945322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407945322 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Other Organization Name | PROVIDENCE CENTRALIA HOSPITAL |
| Practice Address |
914 S Scheuber Rd Centralia WA 98531-9027 |
| Mailing Address |
909 N Broadway Pbo/credentialing Everett WA 98201-1409 |
| Practice Telephone | 3607362803 |
| Mailing Telephone | 4253170246 |
| Mailing Fax Number | 4253170291 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2008-09-21 |
| Authorized Official Name | KATHLEEN NURMI (DIR REVENUE CYCLE MGMT SWSA) |
| Authorized Official Telephone | 3604934081 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 4211918 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Centralia Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407162571 | Providence Health & Services - Washington | Internal Medicine | 510 E Amende Drive, Odessa, WA 99159-0000 | 2010-08-26 |
| 1841503034 | Providence Health & Services - Washington | Family Medicine | 18313 Paulsonst Sw, Suite A, Rochester, WA 98579-9262 | 2010-07-16 |
| 1083947709 | Providence Health & Services - Washington | Hospice Care, Community Based | 2731 Wetmore Ave Ste 500, Everett, WA 98201-3585 | 2009-09-14 |
| 1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
| 1558512368 | Providence Health & Services - Washington | Home Health | 209 W Poplar St, Walla Walla, WA 99362 | 2008-10-10 |
| 1922259738 | Providence Health & Services - Washington | Internal Medicine | 380 Chase Avenue, Pmg Se Wa, Walla Walla, WA 99362-2924 | 2008-10-10 |
| 1306097126 | Providence Health & Services - Washington | Radiology | 401 W Poplar Street, Pmg Se Wa Imaging, Walla Walla, WA 99362-2846 | 2008-10-10 |
| 1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
| 1073677605 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 506 W Franklin St, Shelton, WA 98584-3517 | 2006-12-20 |
| 1003906918 | Providence Health & Services - Washington | Home Health | 3432 Bay Rd Ne, Olympia, WA 98506-2958 | 2006-10-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
914 S SCHEUBER RD |
| City | CENTRALIA |
| State | WA |
| Zip Code | 98531-9027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982600805 | Leena Carriere | Anesthesiology | 914 S Scheuber Rd, Pmg Sw Wa Centralia Anesthesiology, Centralia, WA 98531-9027 | 2005-06-24 |
| 1114542065 | Gary John Clinton Mersereau Sr. | Registered Nurse | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2020-06-16 |
| 1366077745 | Andrew J Maasdam | Nurse Anesthetist, Certified Registered | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2020-03-06 |
| 1447884374 | Michelle Stover | Registered Nurse | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2020-02-29 |
| 1932748993 | Erika Anne Laurentz | Counselor | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2019-12-22 |
| 1952942567 | Ashley Marie Wheeler | Emergency Medicine | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2019-10-04 |
| 1619537057 | Rebecca Kathryn Mcneil | Counselor | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2019-06-18 |
| 1982269395 | Jennifer Green | Physician Assistant | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2019-05-01 |
| 1033698519 | Jennifer Ann Reuter | Physician Assistant | 914 S Scheuber Rd, Centralia, WA 98531 | 2018-08-07 |
| 1629554274 | Rachelle Marie Peterson | Occupational Therapist | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2018-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306462205 | Jelisa Renae Thomas | Counselor | 3510 Steelhammer Ln, Centralia, WA 98531 | 2020-06-17 |
| 1205498607 | Jennifer Kristine Mcglynn Paterno | Counselor | 2428 W. Reynods Ave, Centralia, WA 98531 | 2019-07-05 |
| 1538646328 | Adam Jeffrey Moore | Counselor | 3510 Steelhammer Lane, Centralia, WA 98531 | 2018-07-24 |
| 1144706698 | Euijeong Kim | Occupational Therapist | Rehabilitation Therapies, 914 S. Scheuber Rd, Centralia, WA 98531 | 2018-07-18 |
| 1104315266 | Margaret Fowler Floyd | Registered Nurse | Centralia High School, 813 Eshom Road, Centralia, WA 98531 | 2018-05-04 |
| 1124545777 | Samantha Michelle Moody | Speech-Language Pathologist | Centralia School District, 2320 Borst Ave, Centralia, WA 98531 | 2017-08-24 |
| 1821520289 | Alexa Franks | Behavior Technician | 2428 West Reynolds Ave., Centralia, WA 98531 | 2017-04-03 |
| 1023559861 | Brandy Michelle Peterson | Counselor | 135 W. Main Steet, Centralia, WA 98531 | 2017-03-13 |
| 1841738812 | Graceful Healing Naturopathic | Naturopath | 219 N Tower Ave, Suite 304, Centralia, WA 98531 | 2017-02-09 |
| 1043681513 | Angela Naillon | Counselor | 2428 West Reynolds, Centralia, WA 98531 | 2015-10-09 |
| Find all providers in zip 98531 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457476640 | Brookside Manor LLC | Nursing Facility/Intermediate Care Facility | 1740 W Mccord St, Centralia, IL 62801-5808 | 2007-03-20 |
| 1457476632 | Pinckneyville Healthcare Center LLC | Nursing Facility/Intermediate Care Facility | 708 Virginia Court, Centralia, IL 62801 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639577984 | Arcadia Adult Family Home, LLC | Nursing Facility/Intermediate Care Facility | 910 38th St, Bellingham, WA 98229-3158 | 2014-12-17 |
| 1649510496 | Rio Vista Afh | Nursing Facility/Intermediate Care Facility | 10106 Se French Rd, Vancouver, WA 98664-3726 | 2013-02-14 |
| 1114263225 | David C. Wynecoop, Memorial Clinic | Nursing Facility/Intermediate Care Facility | 928 E Illinois Ave, Spokane, WA 99207-2637 | 2012-12-17 |
| 1467621748 | Va | Nursing Facility/Intermediate Care Facility | 17928 33rd Pl W, Lynnwood, WA 98037-7734 | 2008-02-21 |
| 1063695039 | Janejarah Hang | Nursing Facility/Intermediate Care Facility | 407 E 52nd St, Tacoma, WA 98404-1370 | 2007-12-12 |
| 1699980771 | Life Care Center of America | Nursing Facility/Intermediate Care Facility | 33801 1st Way S Ste 301, Federal Way, WA 98003-4548 | 2007-05-11 |
| 1215157623 | Kelsey Park A.f.h. | Nursing Facility/Intermediate Care Facility | 12649 Se 4th Pl, Bellevue, WA 98005-3507 | 2007-04-26 |
| 1962576777 | Grant County Public Hospital District 2 | Nursing Facility/Intermediate Care Facility | 908 10th Ave Sw, Quincy, WA 98848-1376 | 2006-11-20 |
| 1770520249 | Renton Care Center, Inc | Nursing Facility/Intermediate Care Facility | 80 Sw 2nd St, Renton, WA 98055-1937 | 2006-06-01 |
| 1316984917 | Clay & Davis Development, LLC | Nursing Facility/Intermediate Care Facility | 620 S Hazel St, Arlington, WA 98223-8245 | 2006-06-01 |
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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.