PROVIDENCE HEALTH & SERVICE - WASHINGTON (NPI# 1558554709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558554709 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICE - WASHINGTON |
| Other Organization Name | PROV CENTRLIA INTERNAL MEDICINE |
| Practice Address |
954 Anderson Dr Suite 102 Aberdeen WA 98520-1001 |
| Mailing Address |
Po Box 34439 Seattle WA 98124-1439 |
| Practice Telephone | 3605336906 |
| Mailing Telephone | 4255256778 |
| Mailing Fax Number | 4255256700 |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2010-12-22 |
| Authorized Official Name | NICOLE QUINN (PAYOR CREDENTIALING MANAGER) |
| Authorized Official Telephone | 4255256715 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7139777 | 05 |
| Other Name | Type Code |
|---|---|
| Prov Centrlia Internal Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003009259 | Providence Health & Service - Washington | Internal Medicine | 2015 Cooks Hill Rd, Suite 200, Centralia, WA 98531-9074 | 2007-08-21 |
| 1811942758 | Providence Health & Service - Washington | Radiologic Technologist | 908 S Scheuber Rd, Centralia, WA 98531-9027 | 2006-05-22 |
| 1013100262 | Providence Health & Service - Washington | Internal Medicine | 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 | 2007-08-21 |
| Street Address |
954 ANDERSON DR SUITE 102 |
| City | ABERDEEN |
| State | WA |
| Zip Code | 98520-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467449967 | Brent J Rowe | Surgery | 954 Anderson Dr, Aberdeen, WA 98520-1001 | 2005-09-30 |
| 1356622344 | Damon S Pierce Md Ps | Surgery | 954 Anderson Dr, Ste 108, Aberdeen, WA 98520-1001 | 2011-09-02 |
| 1386763423 | Ann Elizabeth Heikel | Occupational Therapist | 954 Anderson Dr, Aberdeen, WA 98520-1001 | 2007-03-28 |
| 1477681583 | Jonathan Gifford | Surgery | 954 Anderson Dr, Suite 108, Aberdeen, WA 98520-1001 | 2007-03-01 |
| 1982774097 | Western Washington Oncology | Specialist | 954 Anderson Dr, Suite 102, Aberdeen, WA 98520-1001 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740755354 | Wchs, Inc. | Clinic/Center | 516 East 1st Street, Aberdeen, WA 98520 | 2018-10-10 |
| 1518454180 | Katie Cutshaw | Counselor | 1700 Cherry Street, Suite C, Aberdeen, WA 98520 | 2018-04-18 |
| 1629587738 | Robert Williams | Counselor | Catholic Community Services, 403 West State Street, Suite 206, Aberdeen, WA 98520 | 2017-09-21 |
| 1174032296 | Amy D Tyler | Peer Specialist | 403 W State Street, Ste 206, Aberdeen, WA 98520 | 2017-09-20 |
| 1073032819 | Amanda Leona Franklin | Counselor | 2700 Simpson Ave, Suite 101, Aberdeen, WA 98520 | 2017-09-13 |
| 1184141152 | Chrystal Lynn Beckley | Counselor | 2700 Simpson Avenue Suite 101, Aberdeen, WA 98520 | 2017-08-29 |
| 1285158923 | Josh Butler | Technician/Technologist | 1718 Sumner Ave, Aberdeen, WA 98520 | 2017-08-02 |
| 1386165553 | Melvin Taylor | Counselor | 311 South I Street, Aberdeen, WA 98520 | 2017-06-28 |
| 1164870267 | Kelly Knittle | Counselor | 4820 She-nah-num Dr. Se, Olympia, WA 98520 | 2016-05-31 |
| 1437570249 | Aberdeen Therapy Works | Occupational Therapist | 100 S. I Street, Suite 205, Aberdeen, WA 98520 | 2013-12-20 |
| Find all providers in zip 98520 | ||||
| Taxonomy Code | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285286369 | Candice Mccoy | Internal Medicine | 400 Dexter Ave N Ste 1200, Seattle, WA 98109-5094 | 2019-07-10 |
| 1265860027 | Vista Oncology Inc Ps | Internal Medicine | 420 Mcphee Rd Se, Olympia, WA 98502 | 2013-10-14 |
| 1326483587 | Providence Health & Services Mt | Internal Medicine | 24001 East Mission Ave. Ste 105, Providence Healtlh and Services, Montana, Liberty Lake, WA 99019-0012 | 2013-05-01 |
| 1295000552 | Jesse Johnston Salk | Internal Medicine | 1660 S Columbian Way # S-111onc, Seattle, WA 98108-1532 | 2012-03-19 |
| 1962777862 | Charles M Bagley Jr. | Internal Medicine | 1235 8th Ave W, Seattle, WA 98119-3441 | 2012-03-12 |
| 1548556384 | Janghee Woo | Internal Medicine | 825 Eastlake Ave. East, Seattle, WA 98109 | 2011-06-20 |
| 1174849855 | B Chue Consulting, P.s. | Internal Medicine | 2825 Eastlake Ave E Ste 200, Seattle, WA 98102-3085 | 2010-04-20 |
| 1740449602 | Kinsey A Mccormick | Internal Medicine | 1221 Madison St Ste 500, Seattle, WA 98104-1388 | 2008-06-05 |
| 1336310028 | Brian Wayne Goodell | Internal Medicine | 24705 142nd Ave Se, Kent, WA 98042-5152 | 2008-03-20 |
| 1003009259 | Providence Health & Service - Washington | Internal Medicine | 2015 Cooks Hill Rd, Suite 200, Centralia, WA 98531-9074 | 2007-08-21 |
| 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.