PROVIDENCE HEALTH & SERVICE - WASHINGTON


Address: 2015 Cooks Hill Rd, Suite 200, Centralia, WA 98531-9074
Phone: 3603308939

PROVIDENCE HEALTH & SERVICE - WASHINGTON (NPI# 1003009259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003009259
Entity Type Organization
Organization Name PROVIDENCE HEALTH & SERVICE - WASHINGTON
Other Organization Name PROV CENTRLIA INTERNAL MEDICINE
Practice Address 2015 Cooks Hill Rd
Suite 200
Centralia
WA 98531-9074
Mailing Address Po Box 34439
Seattle
WA 98124-1439
Practice Telephone 3603308939
Practice Fax Number 3603308916
Mailing Telephone 4255256778
Mailing Fax Number 4255256700
Enumeration Date 2007-08-21
Last Update Date 2010-12-22
Authorized Official Name NICOLE QUINN (PAYOR CREDENTIALING MANAGER)
Authorized Official Telephone 4255256715
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RX0202X Internal Medicine
Specialization: Medical Oncology
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WA 7139785 05

Other Provider/Organization Names

Other Name Type Code
Prov Centrlia Internal Medicine Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1811942758 Providence Health & Service - Washington Radiologic Technologist 908 S Scheuber Rd, Centralia, WA 98531-9027 2006-05-22
1013100262 Providence Health & Service - Washington Internal Medicine 4525 3rd Ave Se, Suite 200, Lacey, WA 98503-1010 2007-08-21
1558554709 Providence Health & Service - Washington Internal Medicine 954 Anderson Dr, Suite 102, Aberdeen, WA 98520-1001 2007-08-21

Office Location

Street Address 2015 COOKS HILL RD
SUITE 200
City CENTRALIA
State WA
Zip Code 98531-9074

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1306462205 Jelisa Renae Thomas Counselor 3510 Steelhammer Ln, Centralia, WA 98531 2020-06-17
1205498607 Jennifer Kristine Mcglynn Paterno Counselor 2428 W. Reynods Ave, Centralia, WA 98531 2019-07-05
1538646328 Adam Jeffrey Moore Counselor 3510 Steelhammer Lane, Centralia, WA 98531 2018-07-24
1144706698 Euijeong Kim Occupational Therapist Rehabilitation Therapies, 914 S. Scheuber Rd, Centralia, WA 98531 2018-07-18
1104315266 Margaret Fowler Floyd Registered Nurse Centralia High School, 813 Eshom Road, Centralia, WA 98531 2018-05-04
1124545777 Samantha Michelle Moody Speech-Language Pathologist Centralia School District, 2320 Borst Ave, Centralia, WA 98531 2017-08-24
1821520289 Alexa Franks Behavior Technician 2428 West Reynolds Ave., Centralia, WA 98531 2017-04-03
1023559861 Brandy Michelle Peterson Counselor 135 W. Main Steet, Centralia, WA 98531 2017-03-13
1841738812 Graceful Healing Naturopathic Naturopath 219 N Tower Ave, Suite 304, Centralia, WA 98531 2017-02-09
1043681513 Angela Naillon Counselor 2428 West Reynolds, Centralia, WA 98531 2015-10-09
Find all providers in zip 98531

Taxonomy Information

Taxonomy Code 207RX0202X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Medical Oncology

Taxonomy Definition

An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1962698837 University Hematology Oncology Group Inc. Internal Medicine 1052 Martin Luther King Dr, Suite 2, Centralia, IL 62801-3002 2007-09-24

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1285286369 Candice Mccoy Internal Medicine 400 Dexter Ave N Ste 1200, Seattle, WA 98109-5094 2019-07-10
1265860027 Vista Oncology Inc Ps Internal Medicine 420 Mcphee Rd Se, Olympia, WA 98502 2013-10-14
1326483587 Providence Health & Services Mt Internal Medicine 24001 East Mission Ave. Ste 105, Providence Healtlh and Services, Montana, Liberty Lake, WA 99019-0012 2013-05-01
1295000552 Jesse Johnston Salk Internal Medicine 1660 S Columbian Way # S-111onc, Seattle, WA 98108-1532 2012-03-19
1962777862 Charles M Bagley Jr. Internal Medicine 1235 8th Ave W, Seattle, WA 98119-3441 2012-03-12
1548556384 Janghee Woo Internal Medicine 825 Eastlake Ave. East, Seattle, WA 98109 2011-06-20
1174849855 B Chue Consulting, P.s. Internal Medicine 2825 Eastlake Ave E Ste 200, Seattle, WA 98102-3085 2010-04-20
1740449602 Kinsey A Mccormick Internal Medicine 1221 Madison St Ste 500, Seattle, WA 98104-1388 2008-06-05
1336310028 Brian Wayne Goodell Internal Medicine 24705 142nd Ave Se, Kent, WA 98042-5152 2008-03-20
1356562250 Martin Alexander Cheever Internal Medicine 825 Eastlake Ave E # G4-610, Seattle, WA 98109-4405 2007-05-01
Find all providers with the same taxonomy

Competitor

Search similar providers

City CENTRALIA
Zip Code 98531

Improve Information

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Dataset Information

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.

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