PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1740507474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740507474 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Other Organization Name | PPS PSHMC PSYCHIATRIC CENTER |
| Practice Address |
105 W 8th Ave Ste 450e Spokane WA 99204-2302 |
| Mailing Address |
101 W 8th Ave Mother Gamelin Center, 3rd Floor Spokane WA 99204-2307 |
| Practice Telephone | 5094746920 |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2011-02-18 |
| Authorized Official Name | ANSELMO NUNEZ (CHIEF EXECUTIVE) |
| Authorized Official Telephone | 5094746616 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PPS PSHMC PSYCHIATRIC CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740566173 | Providence Physician Services Co | Internal Medicine | 212 Central Ave Suite 440, Spokane, WA 99208 | 2011-10-31 |
| 1295016145 | Providence Physician Services Co | Family Medicine | 801 W. 5th Ave, Suite 307, Spokane, WA 99204 | 2011-09-06 |
| 1619268281 | Providence Physician Services Co | Family Medicine | 100 W. South Ave Chewelah, Chewelah, WA 99109 | 2011-04-29 |
| 1184915829 | Providence Physician Services Co | Family Medicine | 5011 W. Lowell Ave, Seattle, WA 99208-8587 | 2011-04-28 |
| 1578869913 | Providence Physician Services Co | Family Medicine | 12704 E Nora Ave, Ste B, Spokane Valley, WA 99216-1140 | 2011-02-02 |
| 1891001277 | Providence Physician Services Co | Pediatrics | 5901 N Linderwood, Suite 126, Spokane, WA 99207 | 2010-08-24 |
| 1245557917 | Providence Physician Services Co | Obstetrics & Gynecology | 518 Clay Street, Chewelah, WA 99109 | 2010-04-21 |
| 1215223953 | Providence Physician Services Co | Prosthetic/Orthotic Supplier | 101 W 8th Ave, Mother Gamelin Center, 3rd Floor, Spokane, WA 99204-2307 | 2011-06-21 |
| 1336433812 | Providence Physician Services Co | Family Medicine | 104 W 5th Ave, Suite 390e, Spokane, WA 99204 | 2011-06-02 |
| 1053618892 | Providence Physician Services Co | Internal Medicine | 105 W 8th Ave, Ste 550e, Spokane, WA 99204-2302 | 2011-02-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE PHYSICIAN SERVICES CO. | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Street Address |
105 W 8TH AVE STE 450E |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972506814 | Jennifer Kay Pary | Psychiatry & Neurology | 105 W 8th Ave, Suite 318c, Spokane, WA 99204-2302 | 2005-05-24 |
| 1285191346 | Lauren A Earthman | Physician Assistant | 105 W 8th Ave, Spokane, WA 99204-2302 | 2019-02-25 |
| 1285104885 | Jonathan Carmen Panetta | Nurse Practitioner | 105 W 8th Ave, Spokane, WA 99204-2302 | 2018-11-27 |
| 1821516949 | Hayden Ingram | Pharmacist | 105 W 8th Ave, Spokane, WA 99204-2302 | 2017-09-08 |
| 1326573031 | Charlotte Lynch | Advanced Practice Midwife | 105 W 8th Ave, Suite 6020, Spokane, WA 99204-2302 | 2017-05-01 |
| 1336698703 | Jocelyn Diana Christianson | Counselor | 105 W 8th Ave, Suite 332, Spokane, WA 99204-2302 | 2016-09-27 |
| 1972057172 | Ashlee Nicole Bradshaw | Counselor | 105 W 8th Ave, Suite 332, Spokane, WA 99204-2302 | 2016-08-05 |
| 1720439045 | Kristin Martin | Nurse Practitioner | 105 W 8th Ave, Suite 200, Spokane, WA 99204-2302 | 2016-06-28 |
| 1871940809 | Elizabeth Killian | Counselor | 105 W 8th Ave, Ste.332, Spokane, WA 99204-2302 | 2016-05-19 |
| 1962860981 | Mahshid Aghasadeghi | Registered Nurse | 105 W 8th Ave, Suite 6020, Spokane, WA 99204-2302 | 2016-02-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952766 | Nvelup Telehealth Pllc | Psychiatry & Neurology | 804 N Monroe St Ste 502, Spokane, WA 99201-2110 | 2020-08-11 |
| 1609493105 | Voyager Behavioral Health Pllc | Psychiatry & Neurology | 1715 W Rain Ln, Spokane, WA 99208-5091 | 2020-06-30 |
| 1265871578 | Erik Keith Loraas | Psychiatry & Neurology | 5633 N Lidgerwood St Ste 107, Spokane, WA 99208 | 2013-06-19 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1548494461 | Amy Dowell | Psychiatry & Neurology | 324 E Sharp Ave, Spokane, WA 99202-1836 | 2009-05-06 |
| 1346484276 | Sara M Clark | Psychiatry & Neurology | 235 E Rowan Ave Ste 107, Spokane, WA 99207 | 2009-04-22 |
| 1871740571 | Transition Associates Ps | Psychiatry & Neurology | 1704 W 11th Ave, Spokane, WA 99204-4110 | 2008-08-25 |
| 1437338167 | Gregory Belenky | Psychiatry & Neurology | 166 S Coeur Dalene St, #d203, Spokane, WA 99201-6452 | 2007-10-30 |
| 1699811224 | James Clifford Green | Psychiatry & Neurology | 105 West 8th Ave, Ste 408, Spokane, WA 99204-2318 | 2007-01-30 |
| 1689753550 | Rufino R Ramos | Psychiatry & Neurology | 102 S Division St, Spokane, WA 99202-1511 | 2006-11-03 |
| Find all providers in SPOKANE | ||||
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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.