PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1811130156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811130156 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Other Organization Name | PROVIDENCE SMMC SURGERY DME |
| Practice Address |
301 W Poplar St Suites 50 Walla Walla WA 99362-2858 |
| Mailing Address |
209 W Poplar St Po Box 1477 Walla Walla WA 99362-2828 |
| Practice Telephone | 5095225765 |
| Practice Fax Number | 5095225789 |
| Mailing Telephone | 5095225906 |
| Mailing Fax Number | 5095225789 |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2009-04-16 |
| Authorized Official Name | SUSAN A COLUMBER (RCM DIRECTOR) |
| Authorized Official Telephone | 5095225906 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | HAC.FS.0000050 | WA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence SMMC Surgery DME | Other Name - Individual/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 |
| 1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
| 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 |
| 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 ST SUITES 50 |
| City | WALLA WALLA |
| State | WA |
| Zip Code | 99362-2858 |
| 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 |
| 1497254635 | Corey Carson | Physician Assistant | 301 W Poplar St, Walla Walla, WA 99362-2858 | 2018-02-02 |
| 1174814552 | Providence Health & Services - Washington | Durable Medical Equipment & Medical Supplies | 301 W Poplar St, Walla Walla, WA 99362-2858 | 2011-04-20 |
| 1699000901 | Chelane R Fackenthall | Registered Nurse | 301 W Poplar St, Suite 100, Walla Walla, WA 99362-2858 | 2009-10-05 |
| 1417191057 | Providence Health & Services - Washington | Urology | 301 W Poplar St, Suite 50, Walla Walla, WA 99362-2858 | 2009-04-27 |
| 1326282963 | Providence Health & Services - Washington | Otolaryngology | 301 W Poplar St, Suite 210, Walla Walla, WA 99362-2858 | 2009-04-27 |
| 1235373879 | Providence Health & Services - Washington | Internal Medicine | 301 W Poplar St, Suite 100, Walla Walla, WA 99362-2858 | 2009-04-27 |
| 1104070598 | Brianne Nicole Bridgeland | Registered Nurse | 301 W Poplar St, Suite #210, Walla Walla, WA 99362-2858 | 2008-11-11 |
| 1417165382 | Jennifer W Leach | Internal Medicine | 301 W Poplar St, Suite 100, Walla Walla, WA 99362-2858 | 2007-05-21 |
| 1194949594 | Jason Adam Dreyer | Neurological Surgery | 301 W Poplar St, Walla Walla, WA 99362-2858 | 2007-04-13 |
| Find all providers in the same location | ||||
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831159888 | Jill Elizabeth Reiss | Surgery | 77 Wainwright Drive, Walla Walla, WA 99362-3975 | 2006-03-24 |
| 1063648590 | Xondra Alexis Driggs | Surgery | 55 W Tietan St, Walla Walla, WA 99362-4445 | 2009-06-10 |
| 1982610903 | John P Shannon | Surgery | 301 W Poplar, Suite 210, Walla Walla, WA 99362 | 2006-07-31 |
| 1184647513 | Ernest William Steinle | Surgery | 380 Chase Ave, Walla Walla, WA 99362-2924 | 2006-07-26 |
| 1235124959 | Frederick Ian Field | Surgery | 301 W Poplar St, Suite 50, Walla Walla, WA 99362-2858 | 2005-09-19 |
| 1336144989 | Scott G Newbold | Surgery | 55 W Tietan St, Walla Walla, WA 99362-4445 | 2005-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477181758 | Michael Joseph Skerda | Surgery | 747 Broadway Apt 111, Seattle, WA 98122-4307 | 2020-03-31 |
| 1184185779 | Arezu Hajar Monawer | Surgery | 747 Broadway Bldg 10th, Seattle, WA 98122-4307 | 2019-03-27 |
| 1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
| 1659858132 | Vancouver Vein & Surgical Center | Surgery | 13115 Ne 4th St Ste 230, Vancouver, WA 98684-5965 | 2018-07-26 |
| 1457884090 | Michael Edward Parsons | Surgery | 9040 Jackson Ave Attn: Department of Surgery, Tacoma, WA 98431-0001 | 2017-04-11 |
| 1891248969 | Jad Abou-khalil | Surgery | 1430 Summit Ave, Appt 502, Seattle, WA 98122-3533 | 2016-07-25 |
| 1285016196 | Amer Nassar | Surgery | Department of Surgery Education, University of Washington, Box 356410, Seattle, WA 98195-0001 | 2015-06-27 |
| 1477949857 | Richard Stein | Surgery | 4545 8th Ave Ne, Apt 610, Seattle, WA 98105-5795 | 2015-04-12 |
| 1518353044 | Brian Cook | Surgery | 815 Mercer St. Box 358047, Uw Medicine South Lake Union, Seattle, WA 98109-4325 | 2015-04-10 |
| 1770997603 | Qualified Surgical Services Pllc | Surgery | 3697 Cameron Dr Ne, Lacey, WA 98516 | 2014-06-18 |
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| 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.