Kellen Ross Gumm
PROVIDENCE HEALTH AND SERVICES - WA


Address: 122 W 7th Ave, 110 Northwest Heart and Lung Surgical Association, Spokane, WA 99204-2301
Phone: 5094560262

Kellen Ross Gumm (NPI# 1598112211, PAC ID# 2567737711) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.

Physician Overview

Nation Provider ID (NPI) 1598112211
PAC ID by PECOS 2567737711
Professional Enrollment ID I20171013002067
Full Name Kellen Ross Gumm
Organization Legal Name PROVIDENCE HEALTH AND SERVICES - WA
Address 122 W 7th Ave
110 Northwest Heart and Lung Surgical Association
Spokane
WA 99204-2301
Phone Number 5094560262
Gender M
Medical School UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduation Year 2017
Primary Specialty PHYSICIAN ASSISTANT
Group Practice PAC ID 7911069703
Number of Group Practice Members 22
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
500119 MULTICARE VALLEY HOSPITAL
500054 PROVIDENCE SACRED HEART MEDICAL CENTER

Other Locations

Address Phone Organization
101 W 8th Ave, Providence Sacred Heart Medical Center, Spokane, WA 99204-2307 5094743131 PROVIDENCE HEALTH AND SERVICES - WA
122 W 7th Ave, 110 Northwest Heart and Lung Surgical Association, Spokane, WA 99204-2301 5094560262 PROVIDENCE HEALTH AND SERVICES - WA

Organization Information

Organization Legal Name PROVIDENCE HEALTH AND SERVICES - WA
Physicians 20

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Todd S Carran Addiction Medicine Providence Health and Services - Wa 916 Pacific Ave, Everett, WA 98201-4147
Randall L De Jong Nurse Practitioner Providence Health and Services - Wa 916 Pacific Ave, Everett, WA 98201-4147
Shannon M Leach Nurse Practitioner Providence Health and Services - Wa 916 Pacific Ave, Everett, WA 98201-4147
Cheryl M Laflore Nurse Practitioner Providence Health and Services - Wa 900 Pacific Ave, Everett, WA 98201-4168
Anita D Rajwan Nurse Practitioner Providence Health and Services - Wa 1700 13th St, Everett, WA 98201-1689
Kimberly A Boyce Physician Assistant Providence Health and Services - Wa 1321 Colby Ave, Everett, WA 98201-1665
Gina Cadena Forney Family Medicine Providence Health and Services - Wa 916 Pacific Ave, Everett, WA 98201-4147
Joy A Varady Nurse Practitioner Providence Health and Services - Wa 1321 Colby Ave, Everett, WA 98201-1665
Paula Georgette Newman Skomski Nurse Practitioner Providence Health and Services - Wa 1321 Colby Ave, Everett, WA 98201-1665
William E Dickinson Osteopathic Manipulative Medicine Providence Health and Services - Wa 916 Pacific Ave, Everett, WA 98201-4147

Office Location

Street Address 122 W 7TH AVE
110 NORTHWEST HEART AND LUNG SURGICAL ASSOCIATION
City SPOKANE
State WA
Zip 99204-2301

Physicians in the same location

Name Specialty Organization Address
Matthew G Taylor Cardiac Electrophysiology Kootenai Health 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352
Edward J Macinerney Cardiovascular Disease (cardiology) Kootenai Health 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352
Kathrine Lynn Hawley Nurse Practitioner Kootenai Health 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352
Michael P Williams Cardiovascular Disease (cardiology) Kootenai Health 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352
Timothy J Lessmeier Cardiac Electrophysiology Kootenai Health 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352
Kevin M Kavanaugh Interventional Cardiology Kootenai Health 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352
Cody V Reese Physician Assistant Kootenai Health 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352
Dennis B Cooke Interventional Cardiology Kootenai Health 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352
William R Bennett Interventional Cardiology Kootenai Health 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352
Gretchen M Foley Physician Assistant Kootenai Health 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352
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Physicians in the same zip code

Name Specialty Organization Address
Elizabeth K Ohalloran Family Practice Providence Health and Services Washington 105 E 8th Ave, Spokane, WA 99204
Monica M Zherebtsov Pediatric Medicine Providence Health and Services Washington 105 E 8th Ave, Suite 418, Spokane, WA 99204
Mark P Guthrie Chiropractic Healing Center Inc. 1625 W 4th Ave, Suite 200, Spokane, WA 99204-1720
Kathleen D Lavis Chiropractic Healing Center Inc. 1625 W 4th Ave, Suite 200, Spokane, WA 99204-1720
Darcy A Kelly Chiropractic Healing Center Inc. 1625 W 4th Ave, Suite 200, Spokane, WA 99204-1720
Lucy E Peterson Plastic and Reconstructive Surgery 105 W 8th Ave, Spokane, WA 99204-2300
Maria C Cassel Physician Assistant Providence Health and Services - Wa 122 W 7th Ave, Spokane, WA 99204-2301
Michelle Minyoung Rhee Physician Assistant Providence Health and Services - Wa 122 W 7th Ave, Spokane, WA 99204-2301
Anisha Boetel Psychiatry Providence Health and Services Washington 105 W 8th Ave, Suite 450e, Spokane, WA 99204-2302
Eric Cohen Psychiatry Providence Health and Services Washington 105 W 8th Ave, Suite 450e, Spokane, WA 99204-2302
Find all physicians in zip 99204

Competitor

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City SPOKANE
Zip Code 99204
Specialty PHYSICIAN ASSISTANT
City + Specialty SPOKANE + PHYSICIAN ASSISTANT

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Dataset Information

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.

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