PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1245557917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245557917 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Other Organization Name | PPS CHEWELAH OB/GYN |
| Practice Address |
518 Clay Street Chewelah WA 99109 |
| Mailing Address |
101 W 8th Ave Mother Gamelin Center, 3rd Floor Spokane WA 99204-2307 |
| Practice Telephone | 5096843701 |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2011-02-28 |
| Authorized Official Name | ANSELMO NUNEZ (CHIEF EXECUTIVE) |
| Authorized Official Telephone | 5094746616 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PPS CHEWELAH OB/GYN | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740566173 | Providence Physician Services Co | Internal Medicine | 212 Central Ave Suite 440, Spokane, WA 99208 | 2011-10-31 |
| 1295016145 | Providence Physician Services Co | Family Medicine | 801 W. 5th Ave, Suite 307, Spokane, WA 99204 | 2011-09-06 |
| 1619268281 | Providence Physician Services Co | Family Medicine | 100 W. South Ave Chewelah, Chewelah, WA 99109 | 2011-04-29 |
| 1184915829 | Providence Physician Services Co | Family Medicine | 5011 W. Lowell Ave, Seattle, WA 99208-8587 | 2011-04-28 |
| 1578869913 | Providence Physician Services Co | Family Medicine | 12704 E Nora Ave, Ste B, Spokane Valley, WA 99216-1140 | 2011-02-02 |
| 1891001277 | Providence Physician Services Co | Pediatrics | 5901 N Linderwood, Suite 126, Spokane, WA 99207 | 2010-08-24 |
| 1215223953 | Providence Physician Services Co | Prosthetic/Orthotic Supplier | 101 W 8th Ave, Mother Gamelin Center, 3rd Floor, Spokane, WA 99204-2307 | 2011-06-21 |
| 1336433812 | Providence Physician Services Co | Family Medicine | 104 W 5th Ave, Suite 390e, Spokane, WA 99204 | 2011-06-02 |
| 1053618892 | Providence Physician Services Co | Internal Medicine | 105 W 8th Ave, Ste 550e, Spokane, WA 99204-2302 | 2011-02-14 |
| 1356646202 | Providence Physician Services Co | Surgery | 122 W 7th Ave, Ste 420, Spokane, WA 99204-2349 | 2011-01-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE PHYSICIAN SERVICES CO. | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Street Address |
518 CLAY STREET |
| City | CHEWELAH |
| State | WA |
| Zip Code | 99109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609322528 | Providence Health & Services | In Home Supportive Care | 110 S. Third Street E., Chewelah, WA 99109 | 2016-08-31 |
| 1639525157 | Shelley Gail Schreibman | Specialist | 101 N Park Street, Po, Chewelah, WA 99109 | 2016-05-13 |
| 1518361831 | David Stroyan | Pharmacist | 518 E Clay, New Health Programs, Chewelah, WA 99109 | 2014-10-15 |
| 1942554712 | Renee S Thompson | Psychologist | 208 E Clay St, Chewelah, WA 99109 | 2012-11-01 |
| 1356616759 | Paul Michael Cockerham | Physical Therapist | 101 N. Park St., Chewelah, WA 99109 | 2012-03-19 |
| 1669768479 | Lori S King | Veterinarian | 1505 N Pinebrook Dr, Chewelah, WA 99109 | 2011-06-21 |
| 1619268281 | Providence Physician Services Co | Family Medicine | 100 W. South Ave Chewelah, Chewelah, WA 99109 | 2011-04-29 |
| 1033340088 | Scott Anthony Lake | Dentist | 616 E Main, Chewelah, WA 99109 | 2009-08-06 |
| 1659560787 | Robin D Bowman | Counselor | 2264 C. Sand Canyon Road, Chewelah, WA 99109 | 2007-10-15 |
| 1225222888 | Deanna Dawn Norvell | Counselor | 106 S 2nd E, Chewelah, WA 99109 | 2007-08-28 |
| Find all providers in zip 99109 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831659275 | Mary L Chandler | Obstetrics & Gynecology | 6510 151st Pl Se, Bellevue, WA 98006-5026 | 2019-03-21 |
| 1649754441 | Steven R Maynard, Md, Pllc | Obstetrics & Gynecology | 1802 S Yakima Ave Ste 300, Tacoma, WA 98405-5305 | 2018-09-18 |
| 1275982720 | Ralph Nicholas Burns | Obstetrics & Gynecology | 1959 Ne Pacific St Box 356460, Seattle, WA 98195-3233 | 2016-06-06 |
| 1487017299 | Semonti K. Hossain | Obstetrics & Gynecology | 12333 Ne 130th Ln Ste Tan 110, Kirkland, WA 98034-7467 | 2016-03-30 |
| 1538554357 | Hayley Jane Mackinnon | Obstetrics & Gynecology | 1959 Ne Pacific St. Box 356460, University of Washington Department of Obgyn, Seattle, WA 98109 | 2015-03-30 |
| 1033523675 | Tariro Mupombwa | Obstetrics & Gynecology | Virginia Mason Medical Center, 1100 9th Avenue, X8-gyn, Seattle, WA 98104 | 2014-06-11 |
| 1821417973 | Anne Wheeler | Obstetrics & Gynecology | 1 E Main St Ste 360, Auburn, WA 98002-4905 | 2014-04-15 |
| 1710306436 | Prime Health Clinic Pllc | Obstetrics & Gynecology | 1420 3rd St Se Ste 106, Puyallup, WA 98372-3730 | 2014-04-09 |
| 1184047441 | Sea Mar Community Health Center | Obstetrics & Gynecology | 14508 Ne 20th Ave Ste 300, Vancouver, WA 98686-6418 | 2014-01-22 |
| 1902246259 | Horse Heaven Hills Obstetrics and Gynecology Pllc | Obstetrics & Gynecology | 4309 W 27th Pl Ste 302, Kennewick, WA 99338-2909 | 2013-07-01 |
| 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.