PROVIDENCE HEALTH & SERVICES-WA (NPI# 1649615220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649615220 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES-WA |
| Other Organization Name | PROVIDENCE REGIONAL MEDICAL CENTER EVERETT |
| Practice Address |
1321 Colby Ave Everett WA 98201-1665 |
| Mailing Address |
Po Box 3369 Portland OR 97208-3369 |
| Practice Telephone | 4252612000 |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2020-07-06 |
| Authorized Official Name | MR. DONALD WAYNE ANDERSON JR. (ASST SEC FOR ENROLLMENT/DIR REIMB S) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 175F00000X | Naturopath | Other Service Providers | ||
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Regional Medical Center Everett | Doing Business As Name - Organization |
| WEV Medical Hospitalist Team | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1255664652 | Providence Health & Services-wa | Obstetrics & Gynecology | 900 Pacific Ave, Suite 501, Everett, WA 98201-4147 | 2009-09-16 |
| 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 |
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 |
| 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 | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720606130 | Nicole Paige Clark | Hospitalist | 10455 Lincoln Hwy, Everett, PA 15537-7046 | 2020-07-13 |
| 1144366295 | Marc W Mora | Hospitalist | 2930 Maple St, Everett, WA 98201-3832 | 2007-01-29 |
| 1114024528 | Peter K Lee | Hospitalist | 1330 Rockefeller Ave, Everett, WA 98201-1684 | 2006-09-20 |
| 1770689929 | Tracy Spencer | Hospitalist | 1330 Rockefeller Ave, Everett, WA 98201-1684 | 2006-09-15 |
| 1003911744 | Cyrus Rafii | Hospitalist | 1331 Colby Ave, Medical Staff Office, Everett, WA 98201-1665 | 2006-09-14 |
| 1912002569 | Joanne Roberts | Hospitalist | 1330 Rockefeller Ave, Everett, WA 98201-1684 | 2006-09-14 |
| 1215032313 | George Lau | Hospitalist | 1330 Rockefeller Ave, Everett, WA 98201-1684 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1700244647 | Shadi Marie Lanham | Hospitalist | 204 Valleyview Ave, Apt 5, Selah, WA 98942-4007 | 2016-02-06 |
| 1023490059 | Priyanka Attri | Hospitalist | 300 Hospital Parkway, Mt Vernon, WA 98273 | 2015-06-26 |
| 1770713091 | Rebecca Miller Jennings | Hospitalist | 800 Yauger Way Sw, H207, Olympia, WA 98502 | 2009-07-21 |
| 1952553737 | Bhabiswar Tiwari | Hospitalist | 3912 Highlands Blvd, Puyallup, WA 98372-1902 | 2008-10-13 |
| 1457528473 | Evgeniya Gorbacheva | Hospitalist | 365 Indigo Pl Nw, Issaquah, WA 98027-2629 | 2008-05-08 |
| 1548444813 | Arti Desai | Hospitalist | 2001 8th Ave, Suite 400, Seattle, WA 98121 | 2007-12-21 |
| 1821133158 | Erick M Davis | Hospitalist | Schick Shadel Hospital, 12101 Ambaum Blvd Sw, Seattle, WA 98146 | 2007-02-21 |
| 1083692412 | Abdullah Oz | Hospitalist | 24230 18th Pl W, Bothell, WA 98021-9283 | 2006-01-05 |
| 1730177791 | Shiraz S. Ahmed | Hospitalist | 1709 Dock St, Tacoma, WA 98402-3204 | 2005-10-12 |
| 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.