DR. NANCY JANE NEUBAUER (NPI# 1215915723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215915723 |
| Entity Type | Individual |
| Full Name | DR. NANCY JANE NEUBAUER |
| Credential | MD |
| Practice Address |
1321 Colby Ave Providence Everett Medical Center Everett WA 98206 |
| Mailing Address |
19020 33rd Ave W Ste 210 Lynnwood WA 98036-4748 |
| Practice Telephone | 4252612000 |
| Mailing Telephone | 4255631500 |
| Mailing Fax Number | 4255631374 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2018-10-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD00038613 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8210130 | 05 | |
| WA | L&I PROVIDER NUMBER | 174096 | 01 |
| WA | L&I PROVIDER NUMBER | 135541 | 01 |
| WA | L&I PROVIDER NUMBER | 135540 | 01 |
| Street Address |
1321 COLBY AVE PROVIDENCE EVERETT MEDICAL CENTER |
| City | EVERETT |
| State | WA |
| Zip Code | 98206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073519328 | Albert Dominick Pacifico II | Internal Medicine | 1321 Colby Ave, Medical Staff Office, Everett, WA 98201-1665 | 2005-06-22 |
| 1083239610 | Arianna Randolph | Social Worker | 1321 Colby Ave, Everett, WA 98201-1665 | 2020-06-09 |
| 1619527595 | Katherine Doreen Carpenter | Pharmacy Technician | 1321 Colby Ave, C-wing First Floor, Everett, WA 98201 | 2019-09-12 |
| 1396302477 | Ashley L Grieve | Nurse Practitioner | 1321 Colby Ave, Everett, WA 98201-1665 | 2019-05-23 |
| 1588140073 | Naa Afadua Annoh | Nurse Practitioner | 1321 Colby Ave, Everett, WA 98201-1665 | 2018-07-17 |
| 1386170694 | Katherine Mccusker | Nurse Practitioner | 1321 Colby Ave, Everett, WA 98201-1665 | 2017-05-05 |
| 1437602935 | Rebecca Louise Formosa | Nurse Practitioner | 1321 Colby Ave, Everett, WA 98201-1665 | 2016-08-01 |
| 1144673153 | Julie Editha Quandt | Nurse Practitioner | 1321 Colby Ave, Everett, WA 98201-1665 | 2016-07-14 |
| 1013361518 | Rhadika Mccormick Souza | Emergency Medicine | 1321 Colby Ave, Everett, WA 98201-1665 | 2016-04-20 |
| 1013379114 | Katherine Morgan | Internal Medicine | 1321 Colby Ave, Everett, WA 98201-1665 | 2016-03-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457338451 | Philip D. Feliciano | Surgery | 1321 Colby Avenue, Providence Everett Medical Center, Everett, WA 98206 | 2005-12-30 |
| 1649308867 | Menaka Charan | Specialist | 916 Pacific Ave, Everett, WA 98206 | 2007-03-01 |
| 1245290592 | Martin John Pointon | Pathology | 1321 Colby Avenue, Everett, WA 98206 | 2006-03-23 |
| 1063481570 | Cellnetix Labs LLC | Clinical Medical Laboratory | 1321 Colby Avenue, Everett, WA 98206 | 2006-03-16 |
| 1356310866 | Cellnetix Pathology Pllc | Pathology | 1321 Colby Avenue, Everett, WA 98206 | 2006-03-16 |
| 1124097233 | Barry Todd Kahn | Pathology | 1321 Colby Avenue, Everett, WA 98206 | 2006-03-14 |
| 1679541080 | Lawrence Edwin Preshaw | Pathology | 1321 Colby Avenue, Everett, WA 98206 | 2006-03-10 |
| 1437137999 | G. Thomas Ruebel | Radiology | 1321 Colby Avenue, Providence Everett Medical Center, Everett, WA 98206 | 2006-01-05 |
| 1639157191 | Donald R. Peters | Radiology | 1321 Colby Avenue, Providence Everett Medical Center, Everett, WA 98206 | 2006-01-05 |
| 1174932651 | Chase Hillock | Counselor | 2802 Lombard Avenue, Everett, WA 98206-0839 | 2014-08-08 |
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| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023095080 | Virginia Eschbach | Radiology | 728 134th St Sw, Suite # 120, Everett, WA 98204-5322 | 2005-12-29 |
| 1578550240 | Everett Radia LLC | Radiology | 3822 Colby Ave, Everett, WA 98201-4913 | 2005-09-28 |
| 1104440312 | Michael E Castro | Radiology | 1818 121st St Se, Everett, WA 98208-5985 | 2020-06-03 |
| 1518218080 | The Everett Clnic Inc | Radiology | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2012-09-25 |
| 1699067090 | Hilary Ann Brazeal | Radiology | 916 Pacific Ave, Everett, WA 98201-4147 | 2011-05-04 |
| 1497914790 | Radiology Consultants of Washington, Inc., P.s. | Radiology | 3131 Nassau St, Suite 102, Everett, WA 98201-4137 | 2008-06-03 |
| 1407992274 | Duane Walter Krause | Radiology | 728 134th St Sw, Suite 120, Everett, WA 98204-5322 | 2007-01-29 |
| 1124164900 | Janis Maryan Mercker | Radiology | 728 134th St Sw, Suite 120, Everett, WA 98204-5322 | 2007-01-29 |
| 1639191299 | Nancy Shaffer | Radiology | 728 134th St Sw, Suite # 120, Everett, WA 98204-5322 | 2006-07-24 |
| 1619913753 | Western Washington Medical Group Department of Dexa Scan | Radiology | 3216 Norton Ave, Suite 102, Everett, WA 98201-4290 | 2006-06-20 |
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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.