COLVILLE MEDICAL CENTER PS (NPI# 1265402689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265402689 |
| Entity Type | Organization |
| Organization Name | COLVILLE MEDICAL CENTER PS |
| Other Organization Name | NORTHEAST WASHINGTON MEDICAL GROUP |
| Practice Address |
1200 East Columbia Colville WA 99114 |
| Practice Telephone | 5096843701 |
| Practice Fax Number | 5096845817 |
| Mailing Telephone | 5096843701 |
| Mailing Fax Number | 5096845817 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2008-05-14 |
| Authorized Official Name | MR. RONALD G REHN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5096843701 |
| Authorized Official Credential | MPA CMPE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 175F00000X | Naturopath | Other Service Providers | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0001X |
Internal Medicine Specialization: Clinical & Laboratory Immunology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0008X |
Internal Medicine Specialization: Hepatology |
Allopathic & Osteopathic Physicians | ||
| N | 207U00000X | Nuclear Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | MEDICARE NCS | 0401930001 | 01 |
| WA | TRAVELERS RAILROAD MEDICARE | CS6535 | 01 |
| WA | L&I CRIME VICTIMS | 8904105 | 01 |
| WA | L&I | 50500 | 01 |
| WA | 7147903 | 05 |
| Other Name | Type Code |
|---|---|
| Northeast Washington Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295997591 | Colville Medical Center Ps | Family Medicine | 1200 E Columbia Ave, Colville, WA 99114-3354 | 2008-06-27 |
| 1831351139 | Colville Medical Center Ps | Family Medicine | 1200 E Columbia Ave, Colville, WA 99114-3354 | 2008-06-27 |
| Street Address |
1200 EAST COLUMBIA |
| City | COLVILLE |
| State | WA |
| Zip Code | 99114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033774799 | Salamia Mikheyeva | Massage Therapist | 697 Gillette Rd., Colville, WA 99114 | 2019-05-07 |
| 1053897694 | Rochelle Diconti | Counselor | 358 E Birch Ave Ste 101, Colville, WA 99114 | 2018-07-17 |
| 1679073928 | Laurel Shull | Massage Therapist | 298 S. Main St., Suite 208, Colville, WA 99114 | 2018-02-13 |
| 1235638123 | Taylor Vanwicklen | Nurse's Aide | 165 E. Hawthorne Ave, Colville, WA 99114 | 2018-02-06 |
| 1932608833 | Sandra Ingram | Registered Nurse | 165 E. Hawthorne Avenue, Colville, WA 99114 | 2018-02-06 |
| 1831451350 | Catherine M Lochner | Occupational Therapist | 1366 Onion Creek Rd., Colville, WA 99114 | 2012-06-11 |
| 1245552215 | Georgia Rae Goot | Hearing Instrument Specialist | 519 S. Main St., Colville, WA 99114 | 2010-02-18 |
| 1801018619 | David W King | Counselor | 165 E Hawthorne Avenue, Colville, WA 99114 | 2007-05-02 |
| 1497976484 | Jack Darrell Esvelt | Dentist | 181 E 1st, Colville, WA 99114 | 2007-05-01 |
| 1730229709 | Carol H Leach | Registered Nurse | 982 E Columbia Ave Ste 201, Colville, WA 99114 | 2007-02-07 |
| Find all providers in zip 99114 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326206681 | Kal Kelley | Family Medicine | 358 N. Main Street, Colville, WA 99114-7005 | 2008-05-22 |
| 1750311775 | Lon Marsh Hatfield | Family Medicine | 150 S Elm St, Colville, WA 99114-2834 | 2006-07-04 |
| 1730568114 | Kyle Rattray | Family Medicine | 982 E Columbia Ave, Colville, WA 99114-3316 | 2015-05-19 |
| 1528445368 | Kristin Michelle Comstock | Family Medicine | 1200 E Columbia Ave, Colville, WA 99114-3354 | 2015-04-30 |
| 1851778070 | Jill M Neiman | Family Medicine | 1200 E Columbia Ave, Colville, WA 99114-3354 | 2015-04-27 |
| 1568874733 | Katrina Marie Maher | Family Medicine | 1200 E Columbia Ave, Colville, WA 99114 | 2014-05-22 |
| 1902242365 | Joseph Cwik | Family Medicine | 1200 E Columbia Ave, Colville, WA 99114-3354 | 2013-05-13 |
| 1801232301 | Maureen Beardslee | Family Medicine | 1200 E Columbia Ave, Colville, WA 99114-3354 | 2013-05-11 |
| 1083968879 | Providence Health & Services Washington | Family Medicine | 1200 E Columbia Ave, Colville, WA 99114-3354 | 2012-11-01 |
| 1528379518 | Katrina Eileen Gardner | Family Medicine | 1200 E Columbia Ave, Colville, WA 99114-3354 | 2010-06-24 |
| Find all providers in COLVILLE | ||||
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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.