PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1073677605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073677605 |
Entity Type | Organization |
Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
Other Organization Name | PROVIDENCE ST. PETER CHEMICAL DEPENDENCY CENTER |
Practice Address |
506 W Franklin St Shelton WA 98584-3517 |
Mailing Address |
909 N Broadway Pbo/credentialing Everett WA 98201-1409 |
Practice Telephone | 3604328692 |
Mailing Telephone | 4253170246 |
Mailing Fax Number | 4253170291 |
Enumeration Date | 2006-12-20 |
Last Update Date | 2008-09-21 |
Authorized Official Name | KATHLEEN NURMI (DIR REVENUE CYCLE MGMT SWSA) |
Authorized Official Telephone | 3604934081 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 276400000X | Rehabilitation, Substance Use Disorder Unit | Hospital Units |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | 1993062 | 05 |
Other Name | Type Code |
---|---|
Providence St. Peter Chemical Dependency Center | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407162571 | Providence Health & Services - Washington | Internal Medicine | 510 E Amende Drive, Odessa, WA 99159-0000 | 2010-08-26 |
1841503034 | Providence Health & Services - Washington | Family Medicine | 18313 Paulsonst Sw, Suite A, Rochester, WA 98579-9262 | 2010-07-16 |
1083947709 | Providence Health & Services - Washington | Hospice Care, Community Based | 2731 Wetmore Ave Ste 500, Everett, WA 98201-3585 | 2009-09-14 |
1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
1558512368 | Providence Health & Services - Washington | Home Health | 209 W Poplar St, Walla Walla, WA 99362 | 2008-10-10 |
1922259738 | Providence Health & Services - Washington | Internal Medicine | 380 Chase Avenue, Pmg Se Wa, Walla Walla, WA 99362-2924 | 2008-10-10 |
1306097126 | Providence Health & Services - Washington | Radiology | 401 W Poplar Street, Pmg Se Wa Imaging, Walla Walla, WA 99362-2846 | 2008-10-10 |
1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
1003906918 | Providence Health & Services - Washington | Home Health | 3432 Bay Rd Ne, Olympia, WA 98506-2958 | 2006-10-13 |
1376638171 | Providence Health & Services - Washington | Skilled Nursing Facility | 4900 Eagle St, Anchorage, AK 99503-7446 | 2006-10-04 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
Street Address |
506 W FRANKLIN ST |
City | SHELTON |
State | WA |
Zip Code | 98584-3517 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245846252 | Judalyn Evette Gill | Counselor | 506 W Franklin St, Shelton, WA 98584-3517 | 2020-09-16 |
1891340758 | William C Aikman | Counselor | 506 W Franklin St, Shelton, WA 98584-3517 | 2019-08-07 |
1821658766 | Julie Ann Brown | Counselor | 506 W Franklin St, Shelton, WA 98584-3517 | 2019-06-13 |
1619438793 | Janice M Dickinson | Case Manager/Care Coordinator | 506 W Franklin St, Shelton, WA 98584-3517 | 2019-03-29 |
1477014561 | Machel M Ledford | Counselor | 506 W Franklin St, Shelton, WA 98584-3517 | 2019-03-29 |
1083825764 | New Directions Counseling, LLC | Community/Behavioral Health | 506 W Franklin St, Shelton, WA 98584-3518 | 2007-05-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023627478 | Ashley Maria Elena Armstrong | Counselor | 307 W Cota St Shelton, Shelton, WA 98584 | 2020-07-30 |
1962011015 | Perry Philemon Little IIi | Dentist | 503 N 4th St, Shelton, WA 98584 | 2020-07-24 |
1588215271 | Rebecca Lynn Adams | Counselor | 601 West Franklin St, Shelton, WA 98584 | 2019-09-24 |
1366939670 | Robbie Chandler | Social Worker | 807 West Pine, Shelton, WA 98584 | 2018-04-23 |
1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
1306361738 | Christine Lee Woods | Counselor | 58150 E. 66th Road, Miami, OK 98584 | 2017-08-07 |
1174063051 | Claudette V. Selkridge | Counselor | 1620 N. Olympic Hwy, Shelton, WA 98584 | 2017-02-27 |
1003278755 | Edward Charles Herman | Social Worker | 50 Se Bluff Loop Rd., Shelton, WA 98584 | 2016-03-22 |
1023497310 | Darren Cuevas | Family Medicine | 939 Mountain View Dr Ste 100, Shelton, WA 98584 | 2015-05-20 |
1639572977 | Thomas Vincent Phung Duffy | Dentist | 717 W. Railroad Ave., Shelton, WA 98584 | 2014-10-01 |
Find all providers in zip 98584 |
Taxonomy Code | 276400000X |
Grouping | Hospital Units |
Classification | Rehabilitation, Substance Use Disorder Unit |
A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) |
Notes: Source: Department of Defense Regulation 6010.8-R, Chapter 6. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073744850 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 2505 Olympic Hwy N., Ste 140, Shelton, WA 98584-2978 | 2009-07-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770714693 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 508 1/2 Eighth Street, Hoquiam, WA 98550-3521 | 2009-07-28 |
1770614273 | Public Hospital District No 1 of Snohomish County | Rehabilitation, Substance Use Disorder Unit | 17880 147th Avenue Se, Monroe, WA 98272-1014 | 2007-03-08 |
1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
1881758472 | Providence Heath & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 24070 Ne Highway 3, Belfair, WA 98528 | 2006-12-20 |
1346238482 | Changepoint, Inc. | Rehabilitation, Substance Use Disorder Unit | 10621 Ne Coxley Dr, Suite 106, Vancouver, WA 98662-6122 | 2005-10-12 |
1265076293 | Annika Shunta Howard | Rehabilitation, Substance Use Disorder Unit | 1701 18th Ave S, Seattle, WA 98144-4317 | 2019-11-02 |
1407343593 | Tranquility Partners, LLC | Rehabilitation, Substance Use Disorder Unit | 800 Washington Ave N, Long Beach, WA 98631-3806 | 2018-04-16 |
1871899336 | Highline Medical Center Cd Unit | Rehabilitation, Substance Use Disorder Unit | 12844 Military Rd S, Tukwila, WA 98168-3045 | 2011-02-01 |
1043441967 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 24070 Ne State Route 3, Suite A, Belfair, WA 98528-9665 | 2009-07-28 |
1689805509 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 4800 College St Se, Lacey, WA 98503-4389 | 2009-07-28 |
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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.