PROVIDENCE EVERETT MEDICAL CENTER (NPI# 1194829820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194829820 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE EVERETT MEDICAL CENTER |
| Other Organization Name | PEMC MONROE RADIOLOGY |
| Practice Address |
14692 179th Ave Se Suite 100 Monroe WA 98272-1198 |
| Mailing Address |
909 N Broadway Pbo Credentialing Everett WA 98201-1409 |
| Practice Telephone | 3608054711 |
| Practice Fax Number | 3608054750 |
| Mailing Telephone | 4253170699 |
| Mailing Fax Number | 4253170291 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2008-09-23 |
| Authorized Official Name | MRS. JOYCE KOBAYASHI (DIR REVENUE CYCLE MGMT NWSA) |
| Authorized Official Telephone | 4253170186 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| PEMC Monroe Radiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073773198 | Providence Everett Medical Center | Clinic/Center | 4112 Harbour Pointe Blvd, Suite 100, Mukilteo, WA 98275-4700 | 2008-06-12 |
| 1982805784 | Providence Everett Medical Center | Social Worker | 900 Pacific Ave, First Floor, Everett, WA 98201-4168 | 2007-05-30 |
| 1538377957 | Providence Everett Medical Center | Clinical Medical Laboratory | 1321 Colby Ave, Everett, WA 98201-1665 | 2007-05-18 |
| 1063551596 | Providence Everett Medical Center | Clinic/Center | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2007-02-05 |
| 1740344100 | Providence Everett Medical Center | Nutritionist | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2006-12-20 |
| 1255495024 | Providence Everett Medical Center | Nutritionist | 900 Pacific Ave, First Floor, Everett, WA 98201-4168 | 2006-12-19 |
| 1770643629 | Providence Everett Medical Center | Nurse Practitioner | 916 Pacific Ave, 1 South, Everett, WA 98201-4147 | 2006-12-11 |
| 1104993716 | Providence Everett Medical Center | Nurse Practitioner | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2006-11-29 |
| 1447326574 | Providence Everett Medical Center | Clinic/Center | 900 Pacific Ave, Suite 200, Everett, WA 98201-4168 | 2006-11-28 |
| 1992871735 | Providence Everett Medical Center | Clinic/Center | 1001 N Broadway, Suite A-3, Everett, WA 98201-1586 | 2006-11-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE EVERETT MEDICAL CENTER | 1321 Colby Ave, Everett, WA 98206 |
| Street Address |
14692 179TH AVE SE SUITE 100 |
| City | MONROE |
| State | WA |
| Zip Code | 98272-1198 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952342974 | Paul W Boone Jr. | Family Medicine | 14692 179th Ave Se, Suite 500, Monroe, WA 98272-1198 | 2006-06-09 |
| 1215225099 | Providence Health & Services-wa | Midwife | 14692 179th Ave Se, Ste 800, Monroe, WA 98272-1162 | 2011-07-14 |
| 1447547658 | Providence Health & Services-wa | Registered Nurse | 14692 179th Ave Se, Ste 800, Monroe, WA 98272-1162 | 2011-07-08 |
| 1720391758 | Carmela Batallones Andrada | Pharmacist | 14692 179th Ave Se, Monroe, WA 98272-1198 | 2010-07-20 |
| 1902139959 | Priscilla Grace Navaja | Pharmacist | 14692 179th Ave Se, Suite 200, Monroe, WA 98272-1198 | 2009-09-09 |
| 1427282250 | Melissa Dawn Goldsmith | Specialist | 14692 179th Ave Se, Suite 400, Monroe, WA 98272-1198 | 2009-05-07 |
| 1457502551 | Providence Health & Services-wa | Clinic/Center | 14692 179th Ave Se, Suite 100, Monroe, WA 98272-1198 | 2008-10-07 |
| 1538345194 | Foot Care Associates PC | Podiatrist | 14692 179th Ave Se, Monroe, WA 98272 | 2008-01-14 |
| 1366625030 | Harmony Lynn Mckenna-clark | Specialist | 14692 179th Ave Se, Suite 400, Monroe, WA 98272-1198 | 2007-12-17 |
| 1558544098 | Nancy Lynnette Rukman | Specialist | 14692 179th Ave Se, Suite 400, Monroe, WA 98272-1198 | 2007-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710346135 | Kiran Agarwal | Internal Medicine | 17707 W Main St Fl 1, Monroe, WA 98272 | 2016-02-12 |
| 1982073136 | Rochelle Conway Toulouse | Behavioral Analyst | 642 North Street, Monroe, WA 98272 | 2015-09-17 |
| 1740658467 | Casey Jane Bahr | Social Worker | Casey Bahr, C.o. Tru- Sotap, 16550 177th Ave Se, Monroe, WA 98272 | 2015-09-11 |
| 1811395049 | Gianna M Rosewood | Massage Therapist | 101 East Main Street Set 201, Monroe, WA 98272 | 2014-12-22 |
| 1528478609 | Puget Sound Kidney Centers | Clinic/Center | 18121 149th Street Se, Monroe, WA 98272 | 2014-04-29 |
| 1215356878 | Sabiha K Barot | Emergency Medicine | Evergreenhealth Monroe, 14701 179th Ave. Se, Monroe, WA 98272 | 2014-04-10 |
| 1346677986 | Irina Emily Goldstein | Pharmacist | 179th Ave Se, Monroe, WA 98272 | 2013-09-27 |
| 1740612449 | Erik Michael Erxleben | Massage Therapist | 211 West Hill St., Monroe, WA 98272 | 2013-08-05 |
| 1780023796 | Jamie Marlo Selbe | Counselor | 16560 167th St Se, Monroe, WA 98272 | 2013-06-24 |
| 1942644620 | Robin Fenn | Counselor | 14841 179th Ave Se, St 230, Neary Naturopathic Clinic, Monroe, WA 98272 | 2013-04-24 |
| Find all providers in zip 98272 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194760264 | Ouachita Medical Imaging LLC | Clinic/Center | 2008a Louisville Ave, Monroe, LA 71201-6121 | 2006-06-20 |
| 1457502551 | Providence Health & Services-wa | Clinic/Center | 14692 179th Ave Se, Suite 100, Monroe, WA 98272-1198 | 2008-10-07 |
| 1578552709 | St Francis Pet Imaging, LLC | Clinic/Center | 411 Calypso St, Suite 150, Monroe, LA 71201-7506 | 2005-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811431752 | Bows-r-bowties | Clinic/Center | 646 Strander Blvd, Tukwila, WA 98188-2923 | 2016-12-12 |
| 1861775249 | 3d Imaging and Diagnosis LLC | Clinic/Center | 5340 Corporate Center Loop Se Ste A, Lacey, WA 98503-5590 | 2011-09-22 |
| 1073773198 | Providence Everett Medical Center | Clinic/Center | 4112 Harbour Pointe Blvd, Suite 100, Mukilteo, WA 98275-4700 | 2008-06-12 |
| 1285850461 | Brain Matters Imaging Centers | Clinic/Center | 1015 8th Ave North, Seattle, WA 98109-3504 | 2007-04-17 |
| 1790822070 | Advanced Open Imaging LLC | Clinic/Center | 19401 40th Ave West, Suite 140, Lynnwood, WA 98036 | 2007-01-30 |
| 1184790032 | Tra-minw, Ps | Clinic/Center | 34515 9th Ave. South, Federal Way, WA 98003 | 2006-11-24 |
| 1356416705 | Peninsula Medical Imaging, Pllc | Clinic/Center | 675 N. Fifth Ave, Suite 2b, Sequim, WA 98382-3201 | 2006-11-21 |
| 1396814166 | Tra-minw, Ps | Clinic/Center | 2502 S Union Ave, Tacoma, WA 98405-1328 | 2006-11-07 |
| 1588775662 | Lynden Medical X-ray LLC | Clinic/Center | 9310 Hammer Rd, Lynden, WA 98264-9530 | 2006-08-31 |
| 1093750614 | Valley Imaging | Clinic/Center | 314 S 11th Ave, Ste B, Yakima, WA 98902-3214 | 2006-06-18 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PROVIDENCE EVERETT MEDICAL CENTER.
| 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.