PROVIDENCE HEALTH & SERVICES (NPI# 1124331996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124331996 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES |
| Other Organization Name | PROVIDENCE SPOKANE HEART INSTITUTE - DAVENPORT CLINIC |
| Practice Address |
100 3rd St Davenport WA 99122-5008 |
| Mailing Address |
Po Box 3776 Seattle WA 98124-3776 |
| Practice Telephone | 5098387711 |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2010-11-04 |
| Authorized Official Name | KAREN DUNCAN (SR. DIRECTOR OF REVENUE CYCLE MGT) |
| Authorized Official Telephone | 4252545362 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Spokane Heart Institute - Davenport Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609322528 | Providence Health & Services | In Home Supportive Care | 110 S. Third Street E., Chewelah, WA 99109 | 2016-08-31 |
| 1811201312 | Providence Health & Services | Internal Medicine | 715 S Washington, Suite A, Moscow, ID 83843-0000 | 2010-07-27 |
| 1720391659 | Providence Health & Services | Internal Medicine | 629 Jasmine St, Omak, WA 98841 | 2010-07-20 |
| 1114230042 | Providence Health & Services | Internal Medicine | 318 E Rowan Ave, 240, Spokane, WA 99207-1200 | 2010-07-20 |
| 1154539203 | Providence Health & Services | Internal Medicine | 1510 Division St Ste 200, Oregon City, OR 97045-1599 | 2007-05-21 |
| 1780742114 | Providence Health & Services | Internal Medicine | 1515 Portland Rd, Newberg, OR 97132-1844 | 2006-12-05 |
| 1831639731 | Providence Health & Services | Home Health Aide | 12800 Bothell Everett Hwy, Suite 290, Everett, WA 98208-6642 | 2017-02-27 |
| 1093056632 | Providence Health & Services | General Acute Care Hospital | 6801 Coldwater Canyon Ave, Suite 1a, North Hollywood, CA 91605-5162 | 2013-03-06 |
| 1689977159 | Providence Health & Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 700 W Ironwood Dr, Suite 350, Coeur D Alene, ID 83814-2656 | 2010-12-06 |
| 1245544584 | Providence Health & Services | Internal Medicine | 1550 S Pioneer Way, Pioneer Medical Center #250, Moses Lake, WA 98837-4613 | 2010-07-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - MONTANA | 1801 Lind Ave Sw, Renton, WA 98057 |
| Colorado Business Entities | Providence Health & Services - Montana | Dept of Legal Affairs, 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - MONTANA | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Colorado Business Entities | Providence Health & Services - Oregon | 1801 Lind Avenue, Sw, Renton, WA 98057-9016 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 4400 Ne Halsey St Bldg 2 Ste 690, Portland, OR 97213-1545 |
| Iowa Business Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
| Street Address |
100 3RD ST |
| City | DAVENPORT |
| State | WA |
| Zip Code | 99122-5008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497205439 | Lincoln County Hospital District #3 / North Basin Medical Clinics | Health Maintenance Organization | 100 3rd St, Davenport, WA 99122-5008 | 2016-10-13 |
| 1356795959 | Leah Olvera | Massage Therapist | 100 3rd St, Davenport, WA 99122-5008 | 2016-04-20 |
| 1891940789 | Knute J Hernas Dds Ps | Clinic/Center | 100 3rd St, Suite 3, Davenport, WA 99122-5008 | 2008-11-19 |
| 1720126477 | Knute Jonathan Hernas | Dentist | 100 3rd St, Suite 3, Davenport, WA 99122-9730 | 2007-02-02 |
| 1639113830 | Lincoln County Hospital District 3 | Family Medicine | 100 3rd St, Suite 1, Davenport, WA 99122-9730 | 2006-06-16 |
| 1972547610 | Lincoln County Hospital District 3 | Family Medicine | 100 3rd St, Suite 1, Davenport, WA 99122-9730 | 2006-06-15 |
| 1821031410 | Cynthia D. Mccall | Registered Nurse | 100 3rd St, Suite 4, Davenport, WA 99122-9730 | 2006-06-13 |
| 1073554119 | Donella S. Young | Family Medicine | 100 3rd St, Suite 1, Davenport, WA 99122-9730 | 2006-06-09 |
| 1558309518 | Lincoln County Hospital District 3 | Family Medicine | 100 3rd St, Suite 1, Davenport, WA 99122-9730 | 2006-06-03 |
| 1053358465 | Deanna D. Davidson | Surgery | 100 3rd St, Suite 4, Davenport, WA 99122-9730 | 2006-06-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003387697 | Creekside Pharmacy LLC | Pharmacy | 639 Morgan Street, Davenport, WA 99122 | 2018-12-08 |
| 1366959470 | Kandis Rose Paskell | Counselor | 547 Morgan Street, Davenport, WA 99122 | 2018-01-10 |
| 1538567839 | Alyssa Fleming | Speech-Language Pathologist | 28000 Prairie Springs Drive, Davenport, WA 99122 | 2014-12-18 |
| 1477742500 | Daniel W Pitman | Counselor | 1102 8th Street, Davenport, WA 99122 | 2007-10-15 |
| 1730201856 | Capstone Behavioral Health | Counselor | 49 Park Street, Davenport, WA 99122 | 2007-04-06 |
| 1972625762 | David Lee Turner | Dentist | 707 Logan St, Davenport, WA 99122 | 2007-04-04 |
| 1982723318 | Dawn Lorraine Wilcox | Counselor | 49 Park, Unit C, Davenport, WA 99122 | 2007-03-28 |
| 1184789703 | Michael G Van Pevenage | Physical Therapist | 506 Morgan Street, Davenport, WA 99122 | 2006-12-26 |
| 1447323811 | Davenport Vision Clinic, Inc. | Optometrist | 506 8th St, Davenport, WA 99122 | 2006-11-15 |
| 1912002791 | Davenport Pharmacy Inc | Pharmacy | 525 Morgan St, Davenport, WA 99122 | 2006-09-14 |
| Find all providers in zip 99122 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215397203 | Arrhythmia and Cardiovascular Associates, LLC | Internal Medicine | 2320 North Blvd W Ste A, Davenport, FL 33837-8924 | 2016-03-03 |
| 1598042822 | Heart & Vascular Institute of Florida Plc | Internal Medicine | 42721 Highway 27, Suite 102, Davenport, FL 33837-6821 | 2011-11-15 |
| 1669486379 | Saiyed Aonali Mohib | Internal Medicine | 410 Lionel Way, Davenport, FL 33837-7809 | 2006-07-28 |
| 1982632907 | Cardiovascular Medicine PC | Internal Medicine | 1236 E. Rusholme Street, Suite 300, Davenport, IA 52803 | 2006-06-29 |
| 1912986837 | Prakash R Bontu | Internal Medicine | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 | 2006-01-10 |
| 1497080709 | Srikanth Reddy Kasula | Internal Medicine | 1236 E Rusholme St, Ste 300, Davenport, IA 52803-2434 | 2009-10-05 |
| 1457515314 | Yuhning Hu | Internal Medicine | 1236 E Rusholme St Ste 300, Cardiovascular Medicine PC, Davenport, IA 52803-2473 | 2008-07-10 |
| 1871687087 | Michael Joseph Gimbel IIi | Internal Medicine | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2434 | 2006-10-03 |
| 1124007976 | John Randolph Lewis | Internal Medicine | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 | 2006-01-11 |
| 1871572677 | Nidal H Harb | Internal Medicine | 1236 E Rusholme St, Suite 300, Davenport, IA 52803-2473 | 2006-01-11 |
| Find all providers in DAVENPORT | ||||
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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.