PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI# 1982620654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982620654 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES WASHINGTON |
| Other Organization Name | PROVIDENCE ST PETER NEUROSURGERY |
| Practice Address |
615 Lilly Rd Ne Ste 220 Olympia WA 98506-5137 |
| Mailing Address |
Po Box 34439 Seattle WA 98124-1439 |
| Practice Telephone | 3604866150 |
| Practice Fax Number | 3604866155 |
| Mailing Telephone | 4255256778 |
| Mailing Fax Number | 4255256700 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2010-12-22 |
| Authorized Official Name | NICOLE QUINN (PAYOR CREDENTIALING MANAGER) |
| Authorized Official Telephone | 4255256715 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 346002812 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I | 0209404 | 01 |
| WA | 7129679 | 05 | |
| WA | L&I CRIME VICTIMS | 8942114 | 01 |
| Other Name | Type Code |
|---|---|
| Providence St Peter Neurosurgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134656135 | Providence Health & Services Washington | Clinic/Center | 1018 Capitol Way S Ste 300, Olympia, WA 98501-1212 | 2017-05-22 |
| 1023550050 | Providence Health & Services Washington | Psychologist | 225 State Ave Ne, Olympia, WA 98501-6951 | 2016-11-08 |
| 1003367863 | Providence Health & Services Washington | Radiology | 4800 College St Se Ste E, Lacey, WA 98503-4389 | 2016-10-17 |
| 1023563897 | Providence Health & Services Washington | Clinic/Center | 1705 Se Meadowbrook Blvd, Suite 2, College Place, WA 99324-1756 | 2016-08-22 |
| 1457721250 | Providence Health & Services Washington | Clinic/Center | 1200 Basich Blvd, Aberdeen, WA 98520-1035 | 2015-10-06 |
| 1902141500 | Providence Health & Services Washington | Clinical Medical Laboratory | 820 S Mcclellan St Ste Ll10, Spokane, WA 99204-2446 | 2012-12-07 |
| 1881907715 | Providence Health & Services Washington | Internal Medicine | 62 W 7th Ave, Spokane, WA 99204-2321 | 2010-07-20 |
| 1073744850 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 2505 Olympic Hwy N., Ste 140, Shelton, WA 98584-2978 | 2009-07-28 |
| 1770714693 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 508 1/2 Eighth Street, Hoquiam, WA 98550-3521 | 2009-07-28 |
| 1033309604 | Providence Health & Services Washington | Family Medicine | 1450 Northwest Lane Se, Lacey, WA 98503-6908 | 2007-07-30 |
| Street Address |
615 LILLY RD NE STE 220 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5137 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205885290 | Kathy Lucia Savatini | Physician Assistant | 615 Lilly Rd Ne, Ste 100, Olympia, WA 98506-5117 | 2006-05-08 |
| 1639546625 | Kara Markstrom | Physical Therapy Assistant | 615 Lilly Rd Ne, Olympia, WA 98506-5117 | 2015-08-26 |
| 1972845733 | Olympia Orthopaedic Associates Physical Therapy | Physical Therapist | 615 Lilly Rd Ne, Suite 240, Olympia, WA 98506-5117 | 2013-03-20 |
| 1285955054 | Maria Ciani | Obstetrics & Gynecology | 615 Lilly Rd Ne, Suite 200, Olympia, WA 98506-5117 | 2010-06-16 |
| 1821311465 | Jennifer Koleka Kratzer | Advanced Practice Midwife | 615 Lilly Rd Ne, Ste 200, Olympia, WA 98506-5117 | 2010-03-10 |
| 1508189887 | Michelle D Smith | Physician Assistant | 615 Lilly Rd Ne, Olympia, WA 98506-5117 | 2010-03-01 |
| 1992959746 | Gregory Dee Byrd | Orthopaedic Surgery | 615 Lilly Rd Ne, Suite 100, Olympia, WA 98506-5117 | 2008-11-06 |
| 1194976365 | Sarah Terese Calvert | Obstetrics & Gynecology | 615 Lilly Rd Ne, Suite 200, Olympia, WA 98506-5117 | 2008-10-07 |
| 1558531459 | Olympia Orthopaedic Associates, Pllc | Durable Medical Equipment & Medical Supplies | 615 Lilly Rd Ne, Suite 100, Olympia, WA 98506-5117 | 2008-03-06 |
| 1326237637 | Lori Welke | Physician Assistant | 615 Lilly Rd Ne, Ste 100, Olympia, WA 98506-5117 | 2007-10-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| 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 |
|---|---|---|---|---|
| 1336307222 | Edward Peter Hoffman | Neurological Surgery | 3910 Sunset Beach Dr Nw, Olympia, WA 98502-3557 | 2008-05-28 |
| 1457471179 | William Frank Emmons Jr. | Neurological Surgery | 8607 Fernwood St Ne, Olympia, WA 98516 | 2007-03-29 |
| 1427127455 | Robert G.r. Lang | Neurological Surgery | 3525 Ensign Rd Ne Ste J, Olympia, WA 98506-5065 | 2006-11-06 |
| 1548201346 | Brian A Iuliano | Neurological Surgery | 615 Lilly Rd Ne Ste 220, Pmg Sw Wa Neurosurgery, Olympia, WA 98506-5137 | 2006-06-10 |
| 1467618025 | Ryan Jeremiah Halpin | Neurological Surgery | 3901 Capital Mall Dr Sw, Ste A, Olympia, WA 98502-8654 | 2008-08-04 |
| 1417123779 | Sheila M Smitherman | Neurological Surgery | 615 Lilly Rd Ne Ste 200, Pmg Sw Wa Neurosurgery, Olympia, WA 98506-5137 | 2008-05-06 |
| 1447329412 | Robert G.r. Lang, M.d., Inc., P.s. | Neurological Surgery | 3525 Ensign Rd Ne Ste J, Olympia, WA 98506-5065 | 2006-11-06 |
| 1649389263 | Barbara Eileen Lazio | Neurological Surgery | 615 Lilly Rd Ne Ste 220, Olympia, WA 98506-5137 | 2006-08-29 |
| 1396775896 | Yoshihiro Yamamoto | Neurological Surgery | 615 Lilly Rd Ne, Ste. 100, Olympia, WA 98506-5117 | 2006-07-03 |
| 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 |
| 1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
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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.