PROVIDENCE PHYSICIAN SERVICES CO


Address: 122 W 7th Ave, Ste 420, Spokane, WA 99204-2349
Phone: 5098388286

PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1356646202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356646202
Entity Type Organization
Organization Name PROVIDENCE PHYSICIAN SERVICES CO
Other Organization Name PROVIDENCE INLAND VASCULAR INSTITUTE
Practice Address 122 W 7th Ave
Ste 420
Spokane
WA 99204-2349
Mailing Address 101 W 8th Ave
Mother Gamelin Center, 3rd Floor
Spokane
WA 99204-2307
Practice Telephone 5098388286
Enumeration Date 2011-01-24
Last Update Date 2011-03-24
Authorized Official Name ANSELMO NUNEZ (CHIEF EXECUTIVE)
Authorized Official Telephone 5094746616
Authorized Official Credential CE
Is Organization Subpart Y
Parent Organization Name PROVIDENCE PHYSICIAN SERVICES CO

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0129X Surgery
Specialization: Vascular Surgery
600503827 WA Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Providence Inland Vascular Institute Doing Business As Name - Organization

Other Provider IDs and Locations

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
1245557917 Providence Physician Services Co Obstetrics & Gynecology 518 Clay Street, Chewelah, WA 99109 2010-04-21
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

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations PROVIDENCE PHYSICIAN SERVICES CO. 1801 Lind Ave Sw, Renton, WA 98057-3368

Office Location

Street Address 122 W 7TH AVE
STE 420
City SPOKANE
State WA
Zip Code 99204-2349

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720081979 Karen L Wollenberg Registered Nurse 122 W 7th Ave, Suite 450, Spokane, WA 99204-2349 2005-05-23
1508484395 Alia Emilie Soulek Nurse Practitioner 122 W 7th Ave, Spokane, WA 99204-2349 2020-07-08
1194239707 Carrie Joann Estuar Nurse Practitioner 122 W 7th Ave, Spokane, WA 99204-2349 2017-11-20
1942736731 Jessica Keen Nurse Practitioner 122 W 7th Ave, Suite 450, Spokane, WA 99204-2349 2017-05-11
1457887937 Jeremiah Mckee Nurse Practitioner 122 W 7th Ave, Suite 450, Spokane, WA 99204-2349 2017-05-03
1003222845 Kristin Walters Nurse Practitioner 122 W 7th Ave, Suite 450, Spokane, WA 99204-2349 2014-07-01
1851669337 Dacia Kay Murillo Physician Assistant 122 W 7th Ave, Suite 420, Spokane, WA 99204-2349 2011-12-12
1144538158 Ryan Forsyth Physician Assistant 122 W 7th Ave, Suite 420, Spokane, WA 99204-2349 2010-09-24
1043524481 Luke Xiaoli Zhan Surgery 122 W 7th Ave, Suite 420, Spokane, WA 99204-2349 2010-07-27
1801114129 Inland Cardiology Associates Ps Physician Assistant 122 W 7th Ave, Suite 450, Spokane, WA 99204-2332 2010-05-11
Find all providers in the same location

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2086S0129X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Vascular Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1508841966 Stephens Davis Taylor Surgery 910 W 5th Ave Ste 900, Spokane, WA 99204-2948 2005-12-08
1043524481 Luke Xiaoli Zhan Surgery 122 W 7th Ave, Suite 420, Spokane, WA 99204-2349 2010-07-27
1285952085 Lindsay Michelle Gates Surgery 910 W 5th Ave, Suite 900, Spokane, WA 99204-2966 2010-05-04
1235273632 Beejay Feliciano Surgery 910 W 5th Ave Ste 900, Spokane, WA 99204-2948 2007-02-18
1669482154 Adnan Z Rizvi Surgery 122 W 7th Ave, Suite 420, Spokane, WA 99204-2349 2006-08-08
1104874569 Ryan D. Nachreiner Surgery 122 W 7th Ave, Suite 420, Spokane, WA 99204-2349 2006-05-05
1770547572 Hassan Y. Tehrani Surgery 910 W 5th Ave, Suite 1000, Spokane, WA 99204-2966 2006-04-17
1154385847 Mary Kathleen Reilly Surgery 122 W 7th Ave, 410 & 420, Spokane, WA 99204-2349 2006-04-12
1427011394 Stephen P Murray Surgery 122 W 7th Ave, Suite 420, Spokane, WA 99204-2349 2006-04-10
1659334936 Joseph Anton Davis Surgery 122 W 7th Ave, 420, Spokane, WA 99204-2349 2006-04-08
Find all providers in SPOKANE

Competitor

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City SPOKANE
Zip Code 99204

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Dataset Information

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.

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