Cory Nathaniel Mitchell (NPI# 1275943060, PAC ID# 0345531935) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1275943060 |
| PAC ID by PECOS | 0345531935 |
| Professional Enrollment ID | I20181023002927 |
| Full Name | Cory Nathaniel Mitchell |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES - WASHINGTON |
| Address |
1111 S 2nd Ave Walla Wall WA 99362-4118 |
| Phone Number | 5098975174 |
| Gender | M |
| Medical School | LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2014 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | SPORTS MEDICINE |
| Group Practice PAC ID | 2860552973 |
| Number of Group Practice Members | 162 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 500002 | PROVIDENCE ST MARY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1111 S 2nd Ave, Walla Wall, WA 99362-4118 | 5098975174 | PROVIDENCE HEALTH AND SERVICES - WASHINGTON |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES - WASHINGTON |
| Physicians | 212 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Holly Ross Farnam | Physical Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Andrew Meillier | Hospitalist | Providence Health and Services - Washington | 401 W Poplar St, Walla Walla, WA 99362-2846 |
| Johanna Menard | Nurse Practitioner | Providence Health and Services - Washington | 1705 Se Meadowbrook Blvd, Suite 2, College Place, WA 99324-1756 |
| Kortney K Killgore Smith | Nurse Practitioner | Providence Health and Services - Washington | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 |
| Brianne N Bridgeland | Nurse Practitioner | Providence Health and Services - Washington | 380 Chase Ave, Walla Walla, WA 99362-2924 |
| Gordon G Hoffnagle | Certified Registered Nurse Anesthetist (crna) | Providence Health and Services - Washington | 982 E Columbia Ave, Colville, WA 99114-3316 |
| Julie M Rice | Nurse Practitioner | Providence Health and Services - Washington | 18313 Paulson St Sw, Suite A, Rochester, WA 98579-9262 |
| Charles E Nussbaum | Neurosurgery | Providence Health and Services - Washington | 301 W Poplar St, Suite 50, Walla Walla, WA 99362-2800 |
| Adam D Ostrowski | Occupational Therapy | Providence Health and Services - Washington | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 |
| Julie Ann Cooke | Qualified Speech Language Pathologist | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Street Address |
1111 S 2ND AVE |
| City | WALLA WALL |
| State | WA |
| Zip | 99362-4118 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Holly Ross Farnam | Physical Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Julie Ann Cooke | Qualified Speech Language Pathologist | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Patricia Ann Noel | Occupational Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Rachelle L Hartman | Physical Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Christopher John Robert Zita | Physical Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Ricky G Christenson | Physical Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Jeannine Kay Broome | Physical Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Berrit Harriet Estelle Goodman | Occupational Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Mark Mccomas | Physical Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Kyle B Wiley | Physical Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cynthia A Wallace | Clinical Social Worker | 19 E Birch, Suite 103, Walla Walla, WA 99362 | |
| Susan L Stough | Clinical Social Worker | 409 E Sumach St, Suite 6, Walla Walla, WA 99362-1202 | |
| Natasha Anne Rustad | Clinical Social Worker | 409 E Sumach St, Rustad Counseling LLC, Walla Walla, WA 99362-1202 | |
| Pavel S Blagov | Clinical Psychologist | 409 E Sumach St, Suite 3, Walla Walla, WA 99362-1202 | |
| Robert L Stough Jr. | Psychologist, Clinical | 409 E Sumach St, Walla Walla, WA 99362-1228 | |
| Chance Higginbotham | Chiropractic | 2200 Melrose St, 7a, Walla Walla, WA 99362-1579 | |
| Alayna M Brinton | Clinical Social Worker | 2330 Eastgate St, Suite 140, Walla Walla, WA 99362-1589 | |
| Sean Thomas Duffy | Family Medicine | Yakima Valley Farm Workers Clinic | 1120 W Rose St, Walla Walla, WA 99362-1662 |
| Bradley K Nielson | Optometry | 208 N 2nd Ave, Walla Walla, WA 99362-1806 | |
| Eric John Wiessner | Optometry | 614 E Alder St, Suite 1, Walla Walla, WA 99362-2073 | |
| Find all physicians in zip 99362 | |||
| City | WALLA WALL |
| Zip Code | 99362 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | WALLA WALL + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Cory Nathaniel Mitchell.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.