NW CARDIOTHORACIC & TRANSPLANT SURGEONS P.S. (NPI# 1336194703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336194703 |
| Entity Type | Organization |
| Organization Name | NW CARDIOTHORACIC & TRANSPLANT SURGEONS P.S. |
| Other Organization Name | NORTHWEST CARDIOTHORACIC & TRANSPLANT SURGEONS, PS |
| Practice Address |
105 W 8th Ave Suite 532 Spokane WA 99204-2307 |
| Practice Telephone | 5096237575 |
| Practice Fax Number | 5096237578 |
| Mailing Telephone | 5096237575 |
| Mailing Fax Number | 5096237578 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2008-07-09 |
| Authorized Official Name | DR. TIMOTHY B ICENOGLE (PRESIDENT) |
| Authorized Official Telephone | 5096237575 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 204F00000X | Transplant Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I LICENSE NUMBER | 30277 | 01 |
| WA | STATE LICENSE UBI | 601433334 | 01 |
| Other Name | Type Code |
|---|---|
| Northwest Cardiothoracic & Transplant Surgeons, PS | Doing Business As Name - Organization |
| Street Address |
105 W 8TH AVE SUITE 532 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972506814 | Jennifer Kay Pary | Psychiatry & Neurology | 105 W 8th Ave, Suite 318c, Spokane, WA 99204-2302 | 2005-05-24 |
| 1285191346 | Lauren A Earthman | Physician Assistant | 105 W 8th Ave, Spokane, WA 99204-2302 | 2019-02-25 |
| 1285104885 | Jonathan Carmen Panetta | Nurse Practitioner | 105 W 8th Ave, Spokane, WA 99204-2302 | 2018-11-27 |
| 1821516949 | Hayden Ingram | Pharmacist | 105 W 8th Ave, Spokane, WA 99204-2302 | 2017-09-08 |
| 1326573031 | Charlotte Lynch | Advanced Practice Midwife | 105 W 8th Ave, Suite 6020, Spokane, WA 99204-2302 | 2017-05-01 |
| 1336698703 | Jocelyn Diana Christianson | Counselor | 105 W 8th Ave, Suite 332, Spokane, WA 99204-2302 | 2016-09-27 |
| 1972057172 | Ashlee Nicole Bradshaw | Counselor | 105 W 8th Ave, Suite 332, Spokane, WA 99204-2302 | 2016-08-05 |
| 1720439045 | Kristin Martin | Nurse Practitioner | 105 W 8th Ave, Suite 200, Spokane, WA 99204-2302 | 2016-06-28 |
| 1871940809 | Elizabeth Killian | Counselor | 105 W 8th Ave, Ste.332, Spokane, WA 99204-2302 | 2016-05-19 |
| 1962860981 | Mahshid Aghasadeghi | Registered Nurse | 105 W 8th Ave, Suite 6020, Spokane, WA 99204-2302 | 2016-02-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 204F00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Transplant Surgery |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285683029 | Timothy Bock Icenogle | Transplant Surgery | 3415 W Horizon Ave, Spokane, WA 99208-8493 | 2006-05-09 |
| 1205152931 | Providence Physician Services Co | Transplant Surgery | 105 W 8th Ave, Ste 1000, Spokane, WA 99204-2302 | 2010-04-20 |
| 1588848428 | Juan C. Mejia | Transplant Surgery | 105 W 8th Ave, Suite 7050, Spokane, WA 99204-2302 | 2007-12-27 |
| 1972535128 | Okechukwu Ojogho | Transplant Surgery | 105 W 8th Ave, Suite 1000, Spokane, WA 99204-2302 | 2006-07-07 |
| 1730135252 | Todd David Merchen | Transplant Surgery | 105 W 8th Ave, Ste 300, Spokane, WA 99204-2302 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285881441 | Brian O Goertz | Transplant Surgery | 11007 Slater Ave Ne, Kirkland, WA 98033-4605 | 2008-08-19 |
| 1578501979 | Swedish Health Service | Transplant Surgery | 1100 Madison St, Ste 200, Seattle, WA 98104-1335 | 2006-06-04 |
| 1477992949 | Peter Joseph Montano Edpao | Transplant Surgery | 1959 Ne Pacific St, Seattle, WA 98195 | 2013-06-18 |
| 1134403215 | Imran Javed | Transplant Surgery | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2011-10-06 |
| 1053592055 | Philip M Karuman | Transplant Surgery | 7425 Wrigley Dr Ste 204, Pasco, WA 99301-5292 | 2007-11-19 |
| 1790904530 | Austin L Spitzer | Transplant Surgery | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2007-04-24 |
| 1588712376 | Virginia Mason Medical Center | Transplant Surgery | 1100 9th Ave, Seattle, WA 98101-2756 | 2007-01-08 |
| 1942365705 | Willam H Marks | Transplant Surgery | 1101 Madison St, Ste 200, Seattle, WA 98104-1306 | 2006-12-22 |
| 1104987387 | Adam E Levy | Transplant Surgery | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2006-12-12 |
| 1316014574 | Lena Sibulesky | Transplant Surgery | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2006-11-30 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on NW CARDIOTHORACIC & TRANSPLANT SURGEONS P.S..
| 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.