PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1760636690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760636690 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Other Organization Name | PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON NEUROSURGERY |
| Practice Address |
301 W Poplar Street Ste 220 Walla Walla WA 99362-2800 |
| Mailing Address |
Po Box 34439 Mailing / Credentialing Seattle WA 98124-1439 |
| Practice Telephone | 5095221030 |
| Practice Fax Number | 5095268402 |
| Mailing Telephone | 5095298905 |
| Mailing Fax Number | 5095268402 |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2012-09-25 |
| Authorized Official Name | MICHAEL PARENTEAU (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5095225890 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | H-050 | WA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Medical Group Southeast Washington Neurosurgery | 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 |
| 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 |
| 1376638171 | Providence Health & Services - Washington | Skilled Nursing Facility | 4900 Eagle St, Anchorage, AK 99503-7446 | 2006-10-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
301 W POPLAR STREET STE 220 |
| City | WALLA WALLA |
| State | WA |
| Zip Code | 99362-2800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164065959 | Kevin Gia-minh Phan | Optometrist | Walla Walla Vamc Bldg 86, Walla Walla, WA 99362 | 2019-10-24 |
| 1659836401 | Arlene Lavonne Whitney | Social Worker | 1361 Dalles Military Road, Walla Walla, WA 99362 | 2019-02-06 |
| 1053880674 | Julie Ann Cooke | Speech-Language Pathologist | Providence St. Mary Medical Center, 401 W. Poplar St., Walla Walla, WA 99362 | 2018-11-14 |
| 1558887133 | Chantey Walker | Massage Therapist | 1840 Pleasant St, Walla Walla, WA 99362 | 2017-08-16 |
| 1447798723 | Carrie S Diede | Speech-Language Pathologist | 410 West Poplar Street, Rehabilitation Services, Walla Walla, WA 99362 | 2017-02-07 |
| 1235584103 | Anchor Point Counseling Pllc | Clinic/Center | 2330 Eastgate St. Ste. 140, Walla Walla, WA 99362 | 2016-04-28 |
| 1548627011 | Washington State Walla Walla Veterans Home | Skilled Nursing Facility | 92 Wainwright Drive, Walla Walla, WA 99362 | 2016-01-28 |
| 1073926200 | Sherry Goff | Registered Nurse | 11120 W Rose St, Family Medical Center, Walla Walla, WA 99362 | 2014-06-05 |
| 1538597935 | Michael Wade Gillespie | Orthopaedic Surgery | 101 Brookside Drive, Walla Walla, WA 99362 | 2013-10-22 |
| 1023357985 | Sandra Kay Bushnell | Speech-Language Pathologist | 1105 Isaacs Ave, Walla Walla, WA 99362 | 2013-02-12 |
| Find all providers in zip 99362 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164427456 | Guy Frank Gehling | Neurological Surgery | 301 W Poplar St, Ste 220, Walla Walla, WA 99362-2858 | 2005-06-14 |
| 1194949594 | Jason Adam Dreyer | Neurological Surgery | 301 W Poplar St, Walla Walla, WA 99362-2858 | 2007-04-13 |
| 1871503805 | Perry E Camp Md Ps | Neurological Surgery | 301 W Poplar St, Ste 220, Walla Walla, WA 99362-2858 | 2006-08-09 |
| 1992715932 | Guy F Gehling Md Ps | Neurological Surgery | 301 W Poplar St, Ste 220, Walla Walla, WA 99362-2858 | 2006-08-09 |
| 1518962166 | Perry E Camp | Neurological Surgery | 301 W Poplar St, Ste 220, Walla Walla, WA 99362-2858 | 2005-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306311386 | David W. Newell M.d. P.s. | Neurological Surgery | 1370 116th Ave Ne Ste 105, Bellevue, WA 98004-3825 | 2018-10-05 |
| 1891243820 | Kiana Uylukcu | Neurological Surgery | Medex Northwest, 4311 11th Avenue Ne, Suite 200, Seattle, WA 98105-3007 | 2016-09-19 |
| 1346691953 | James M Blue | Neurological Surgery | 4882 Forest Ave S.e., Mercer Island, WA 98040 | 2016-06-24 |
| 1427406883 | Fourth Corner Neurosurgical Associates | Neurological Surgery | 710 Birchwood Ave Ste 101, Bellingham, WA 98225-1720 | 2016-05-26 |
| 1659618510 | Antonio A Moure | Neurological Surgery | 1521 2nd Ave, Apartment 1400, Seattle, WA 98101-4500 | 2013-01-12 |
| 1699033894 | Calvin Curtis Whaley | Neurological Surgery | 550 17th Ave Ste 110, Seattle, WA 98122-5789 | 2012-04-25 |
| 1760752240 | David Elbert Grayson | Neurological Surgery | 17625 Se 45th Pl, Bellevue, WA 98006-6520 | 2011-12-30 |
| 1366734063 | Northwest Spine, Pllc | Neurological Surgery | 1017 S 40th Ave, Yakima, WA 98908-3805 | 2011-05-12 |
| 1396050845 | Vincent Edward Bryan Jr. | Neurological Surgery | 342 Silica Rd Nw, Quincy, WA 98848-9468 | 2010-08-09 |
| 1649420019 | Wa-spok Medical Care LLC | Neurological Surgery | 801 W Fifth Ave, Suite 422, Spokane, WA 99204-2841 | 2008-09-23 |
| Find all providers with the same taxonomy | ||||
| City | WALLA WALLA |
| Zip Code | 99362 |
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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.