PROVIDENCE HEALTH & SERVICES - WA (NPI# 1013169507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013169507 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WA |
| Other Organization Name | PMG NW WA MC URGENT CARE |
| Practice Address |
12800 Bothell Everett Hwy Suite 120 Everett WA 98208-6642 |
| Mailing Address |
Po Box 3360 Portland OR 97208-3360 |
| Practice Telephone | 4253165150 |
| Practice Fax Number | 4252251006 |
| Mailing Telephone | 8663992983 |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2015-05-19 |
| Authorized Official Name | PAULA WOOD (PROVIDER CONCIERGE) |
| Authorized Official Telephone | 4252614082 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PMG NW WA MC Urgent Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215189808 | Providence Health & Services - Wa | Home Health | 1000 N Argonne Rd, Spokane Valley, WA 99212 | 2008-10-15 |
| 1750783759 | Providence Health & Services - Wa | Pharmacy | 916 Pacific Ave, Everett, WA 98201-4147 | 2014-09-22 |
| 1972927267 | Providence Health & Services - Wa | Emergency Response System Companies | 2731 Wetmore Ave, Suite 500, Everett, WA 98201-3571 | 2014-02-07 |
| 1770877227 | Providence Health & Services - Wa | General Practice | 1830 Bickford Ave, Suite 211, Snohomish, WA 98290-1749 | 2011-06-01 |
| 1639468259 | Providence Health & Services - Wa | Orthopaedic Surgery | 1717 13th St, Suite 401, Everett, WA 98201-1621 | 2011-04-05 |
| 1225335425 | Providence Health & Services - Wa | Surgery | 1330 Rockefeller Ave, Ste 520, Everett, WA 98201-1684 | 2011-02-24 |
| 1649402231 | Providence Health & Services - Wa | Social Worker | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2009-08-14 |
| 1861622557 | Providence Health & Services - Wa | Social Worker | 12800 Bothell Everett Hwy, Suite 110, Everett, WA 98208-6642 | 2009-07-16 |
| 1265669451 | Providence Health & Services - Wa | Clinic/Center | 101 W 8th Ave, Women's Health Center, Spokane, WA 99204-2307 | 2009-06-16 |
| 1669616363 | Providence Health & Services - Wa | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2009-04-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
12800 BOTHELL EVERETT HWY SUITE 120 |
| City | EVERETT |
| State | WA |
| Zip Code | 98208-6642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518963404 | James Daniel Bass | Family Medicine | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2005-06-24 |
| 1437620499 | Laboratory Corporation of America | Clinical Medical Laboratory | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2018-12-16 |
| 1306375563 | Coreyanne L Griffin | Counselor | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2017-06-09 |
| 1407389448 | Bushra Rahman | Internal Medicine | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2017-04-06 |
| 1831639731 | Providence Health & Services | Home Health Aide | 12800 Bothell Everett Hwy, Suite 290, Everett, WA 98208-6642 | 2017-02-27 |
| 1700325826 | Caroline Judd | Social Worker | 12800 Bothell Everett Hwy, Everett, WA 98208-6642 | 2017-02-22 |
| 1225485550 | Amy Barrows | Nurse Practitioner | 12800 Bothell Everett Hwy, Suite 120, Everett, WA 98208-6642 | 2016-05-17 |
| 1104299601 | Gary Dale Montgomery | Physician Assistant | 12800 Bothell Everett Hwy, Ste A, Everett, WA 98208-6642 | 2015-11-05 |
| 1457731556 | Laura Knapp | Counselor | 12800 Bothell Everett Hwy, Suite 290, Everett, WA 98208-6642 | 2015-06-03 |
| 1174903603 | Justin Gill | Nurse Practitioner | 12800 Bothell Everett Hwy, Everett, WA 98208 | 2015-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790270296 | Kenneth Britt Dyer | Registered Nurse | 10333 19th Ave, Se, Ste #109, Everett, WA 98208 | 2018-06-27 |
| 1518482215 | Glacier Peak Healthcare, Inc. | Home Health | 10530 19th Ave Se Ste 201, Everett, WA 98208 | 2017-08-03 |
| 1114454865 | Aliza Kreisman | Registered Nurse | 11020 19th Avenue Se, Kaiser Permanente of Washington Seattle Care Clinic, Everett, WA 98208 | 2017-05-12 |
| 1902269418 | Clay Eakin | Counselor | 2732 Grand Evenue, Everett, WA 98208 | 2016-04-01 |
| 1467810259 | Elizabeth Anne Powley | Marriage & Family Therapist | 1920 100th Street Southeast, Bld C3, Everett, WA 98208 | 2016-02-08 |
| 1659745842 | Andrea Rose Bedlington | Pharmacist | 11407 33rd Dr. Se, Everett, WA 98208 | 2015-11-25 |
| 1396123865 | Sound Surgeons Pllc | Clinic/Center | 125 130th Street Se, 1st Floor, Everett, WA 98208 | 2015-05-15 |
| 1831576537 | Chris Sturgeon | Counselor | 10102 Meridian Ave, Everett, WA 98208 | 2015-05-01 |
| 1982011128 | James M Lee | Physical Therapist | 10821 19th Ave Se Ste 102, Everett, WA 98208 | 2014-07-21 |
| 1972937357 | Ronald Tracy | Dentist | 10315 19th Avenue Se Suite 110, Everett, WA 98208 | 2013-08-21 |
| Find all providers in zip 98208 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063551752 | James D Leitzell | General Practice | 7601 Evergreen Way Ste B6, Everett, WA 98203-6433 | 2007-02-06 |
| 1164747242 | Providence Health & Services-wa | General Practice | 1717 13th Street, Everett, WA 98201-1621 | 2010-04-01 |
| 1124270715 | Providence Health & Services-wa | General Practice | 900 Pacific Ave, Ste 501, Everett, WA 98201-4168 | 2008-10-15 |
| 1215148275 | John F Yee, Md, PC | General Practice | 596 Broadway, Everett, MA 02149-3743 | 2007-05-24 |
| 1871634691 | Randal C Franke | General Practice | 11001 31st Pl W, Suite 1, Everett, WA 98204-1323 | 2007-02-12 |
| 1407810856 | John Francis Yee | General Practice | 596 Broadway, Everett, MA 02149-3743 | 2006-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063971703 | Source Northwest Integrative Medicine | General Practice | 7206 267th St Nw Ste 102, Stanwood, WA 98292-6269 | 2019-03-12 |
| 1255896601 | Emily Christine Buck | General Practice | 940 Fitzsimmons Dr, Tacoma, WA 98431-0001 | 2019-02-08 |
| 1740755651 | Alyssa Ann Yruegas | General Practice | 2108 W Spruce St, Moses Lake, WA 98837-2853 | 2018-10-06 |
| 1306321237 | Rainier Springs Physician Group, LLC | General Practice | 2805 Ne 129th Street, Vancouver, WA 98686 | 2018-09-26 |
| 1962916437 | Parkview Medical Group Inc | General Practice | 615 S Division St Ste A, Moses Lake, WA 98837-3800 | 2017-11-20 |
| 1790212496 | Thien Thanh Ho | General Practice | 12307 Douglas Rd, Yakima, WA 98908-9129 | 2017-05-12 |
| 1285173625 | Regenerative Medicine Institute, Pllc | General Practice | 731 N Stanley St, Medical Lake, WA 99022-8940 | 2017-02-17 |
| 1457708430 | James Bailey | General Practice | 9040 Jackson Ave Tripler Army Medical Center, Tacoma, WA 98431-5001 | 2016-05-19 |
| 1740635887 | Peter Chulhi Kang | General Practice | 1425 Spring St Apt 802, Seattle, WA 98104-1635 | 2016-04-26 |
| 1831551084 | Anna Hackenmiller | General Practice | 1657 S Nettleton Ln, Spokane, WA 99224-6108 | 2016-03-27 |
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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.