PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI# 1134656135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134656135 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES WASHINGTON |
| Other Organization Name | PROVIDENCE MEDICAL GROUP SOUTHWEST WASHINGTON |
| Practice Address |
1018 Capitol Way S Ste 300 Olympia WA 98501-1212 |
| Mailing Address |
Po Box 3360 Portland OR 97208-3360 |
| Practice Telephone | 3604866508 |
| Practice Fax Number | 3605702077 |
| Mailing Telephone | 3604866508 |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2017-11-26 |
| Authorized Official Name | DONALD W ANDERSON JR. (ASST SEC FOR ENROLLMENT / DIR REIMB) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Medical Group Southwest Washington | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023550050 | Providence Health & Services Washington | Psychologist | 225 State Ave Ne, Olympia, WA 98501-6951 | 2016-11-08 |
| 1003367863 | Providence Health & Services Washington | Radiology | 4800 College St Se Ste E, Lacey, WA 98503-4389 | 2016-10-17 |
| 1023563897 | Providence Health & Services Washington | Clinic/Center | 1705 Se Meadowbrook Blvd, Suite 2, College Place, WA 99324-1756 | 2016-08-22 |
| 1457721250 | Providence Health & Services Washington | Clinic/Center | 1200 Basich Blvd, Aberdeen, WA 98520-1035 | 2015-10-06 |
| 1902141500 | Providence Health & Services Washington | Clinical Medical Laboratory | 820 S Mcclellan St Ste Ll10, Spokane, WA 99204-2446 | 2012-12-07 |
| 1881907715 | Providence Health & Services Washington | Internal Medicine | 62 W 7th Ave, Spokane, WA 99204-2321 | 2010-07-20 |
| 1073744850 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 2505 Olympic Hwy N., Ste 140, Shelton, WA 98584-2978 | 2009-07-28 |
| 1770714693 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 508 1/2 Eighth Street, Hoquiam, WA 98550-3521 | 2009-07-28 |
| 1033309604 | Providence Health & Services Washington | Family Medicine | 1450 Northwest Lane Se, Lacey, WA 98503-6908 | 2007-07-30 |
| 1407055759 | Providence Health & Services Washington | Rehabilitation Unit | 410 Providence Ln., Building 2, Olympia, WA 98506-5101 | 2007-07-17 |
| Street Address |
1018 CAPITOL WAY S STE 300 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98501-1212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124651880 | Marie T Bendig | Counselor | 900 Fairview St Se, #b5, Olympia, WA 98501 | 2020-02-20 |
| 1205469970 | Thurston County Fire Protection Dist 6 | Ambulance | 8047 Normandy St. Se, Olympia, WA 98501 | 2020-02-20 |
| 1134768799 | Living Sound Therapeutic Services, Pllc | Counselor | 729 Devoe St Se, Olympia, WA 98501 | 2019-12-31 |
| 1336797273 | Sea-mar Community Health Center | Dentist | 6004 Capitol Ave Sw, Tumwater, WA 98501 | 2019-09-03 |
| 1093272841 | Eye Love Pllc | Optometrist | 3409 Capitol Blvd Se, Tumwater, WA 98501 | 2019-02-28 |
| 1356815062 | Kerri Wright | Marriage & Family Therapist | 208 Lee St Sw Ste 108, Tumwater, WA 98501 | 2019-01-15 |
| 1952881161 | Paige Gautreaux | Peer Specialist | 908 5th Avenue Se, Olympia, WA 98501 | 2018-08-16 |
| 1548773997 | Carla Van Dam | Psychologist | 2620 Rw Johnson Blvd Sw Suite 204, Tumwater, WA 98501 | 2017-11-08 |
| 1528577202 | Ronald John San Nicolas | Counselor | 1011 10th Ave, Olympia, WA 98501 | 2017-09-25 |
| 1063964187 | Emily Rapesak | Pharmacist | 500 Cleveland Ave Se, Tumwater, WA 98501 | 2016-10-25 |
| Find all providers in zip 98501 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790843290 | Dich Quoc Vu | General Practice | 146 Milroy Street, Olympia, WA 98502 | 2006-12-05 |
| 1639188824 | Patricia Ruth Sylwester | General Practice | 1801 W Bay Dr Nw, Suite 208a, Olympia, WA 98502-4310 | 2006-08-05 |
| 1619099843 | Diana T Yu | General Practice | 412 Lilly Rd Ne, Olympia, WA 98506-5132 | 2007-04-06 |
| 1851456081 | Fernando Irizarry | General Practice | 700 Lilly Rd Ne, Olympia, WA 98506-5115 | 2006-12-27 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.