PROVIDENCE HEALTH & SERVICES WA (NPI# 1750520516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750520516 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES WA |
| Other Organization Name | PMG NW WA GYNECOLOGIC ONCOLOGY ASSOCIATES |
| Practice Address |
1717 13th Street Suite 300 Everett WA 98201-1621 |
| Mailing Address |
Po Box 3360 Portland OR 97208-3360 |
| Practice Telephone | 4252975660 |
| Practice Fax Number | 4252975505 |
| Mailing Telephone | 8663992983 |
| Enumeration Date | 2009-02-18 |
| Last Update Date | 2015-05-19 |
| Authorized Official Name | PAULA WOOD (PROVIDER CONCIERGE) |
| Authorized Official Telephone | 8663992983 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
WA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PMG NW WA Gynecologic Oncology Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811226038 | Providence Health & Services Wa | Clinic/Center | 16708 Bothell Everett Highway, Suite 102, Mill Creek, WA 98012-6329 | 2009-12-17 |
| 1861623548 | Providence Health & Services Wa | Internal Medicine | 1217 Cooper Point Rd Sw, Suite B, Olympia, WA 98502-7206 | 2009-07-29 |
| 1326585779 | Providence Health & Services Wa | Case Management | 44 W 6th Ave, Suite 218, Spokane, WA 99204-2306 | 2017-01-24 |
| 1033558457 | Providence Health & Services Wa | Pharmacy | 401 W Poplar St, Pharmacy, Walla Walla, WA 99362-2846 | 2013-06-19 |
| 1609105832 | Providence Health & Services Wa | Clinic/Center | 16708 Bothell Everett Highway, Suite 201, Mill Creek, WA 98012-6329 | 2009-12-17 |
| Street Address |
1717 13TH STREET SUITE 300 |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-1621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164747242 | Providence Health & Services-wa | General Practice | 1717 13th Street, Everett, WA 98201-1621 | 2010-04-01 |
| 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 | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619992724 | Amy Elizabeth Bondurant | Obstetrics & Gynecology | 1101 Madison St Ste 1500, Seattle, WA 98104-3551 | 2006-07-12 |
| 1235192584 | Michael Allan Bidus | Obstetrics & Gynecology | 11511 Canterwood Blvd Nw Ste 100, Gig Harbor, WA 98332 | 2006-04-08 |
| 1902892987 | Melanie Kim Bergman | Obstetrics & Gynecology | 101 W 8th Ave Ste 1400, Spokane, WA 99204-2307 | 2005-09-23 |
| 1497249932 | Jaycee Wong | Obstetrics & Gynecology | 1003 S 5th St, Tacoma, WA 98405-4210 | 2018-06-19 |
| 1982947149 | Deirdre Knobeloch | Obstetrics & Gynecology | 1560 N 115th St Ste 101, Seattle, WA 98133 | 2013-04-05 |
| 1528303336 | Christopher Michael Tarney | Obstetrics & Gynecology | 9040 Jackson Ave, Tacoma, WA 98431-7075 | 2012-12-05 |
| 1750529244 | Franciscan Medical Group | Obstetrics & Gynecology | 1624 S I St, Tacoma, WA 98405-5016 | 2009-01-22 |
| 1508028788 | Kemi Morenikeji Doll | Obstetrics & Gynecology | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2008-06-27 |
| 1093999740 | Renata Rose Urban | Obstetrics & Gynecology | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2007-12-18 |
| 1871773226 | Gynecology Cancer Clinic Tr | Obstetrics & Gynecology | 1560 N 115th St, Suite 101, Seattle, WA 98133-8414 | 2007-11-13 |
| 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.