PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1396062022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396062022 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Other Organization Name | PROVIDENCE LUNG AND SLEEP DISORDER CLINIC |
| Practice Address |
212 E Central Ave Ste 315 Spokane WA 99208-6291 |
| Mailing Address |
101 W 8th Ave Mother Gamelin Center, 3rd Floor Spokane WA 99204-2307 |
| Practice Telephone | 5092529602 |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2011-02-18 |
| 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 | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PROVIDENCE LUNG AND SLEEP DISORDER CLINIC | 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 |
| 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE PHYSICIAN SERVICES CO. | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Street Address |
212 E CENTRAL AVE STE 315 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99208-6291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477550572 | Philip Coff | Internal Medicine | 212 E Central Ave, Suite 440, Spokane, WA 99208-6291 | 2005-07-05 |
| 1881059954 | Providence Health & Services Washington | Prosthetic/Orthotic Supplier | 212 E Central Ave, Suite 245, Spokane, WA 99208-6291 | 2015-12-16 |
| 1881096774 | Timothy Brim | Physician Assistant | 212 E Central Ave, Suite 365, Spokane, WA 99208-6291 | 2014-09-23 |
| 1295135598 | Providence Physician Services Co. | Orthopaedic Surgery | 212 E Central Ave, Suite 245, Spokane, WA 99208-6291 | 2014-08-25 |
| 1841605433 | Nicole Breen | Family Medicine | 212 E Central Ave, Spokane, WA 99208-6291 | 2014-06-23 |
| 1154614469 | Jessica Renae Craddock | Internal Medicine | 212 E Central Ave, Suite 440, Spokane, WA 99208-6291 | 2011-05-19 |
| 1639471667 | Daniel J Simon | Physician Assistant | 212 E Central Ave, Suite 440, Spokane, WA 99208-6291 | 2010-11-24 |
| 1609182070 | David Bryan Ramey | Psychiatry & Neurology | 212 E Central Ave, Suite 315, Spokane, WA 99208-6291 | 2010-08-24 |
| 1942513874 | Providence Health & Services - Washington | Internal Medicine | 212 E Central Ave, Suite 240, Spokane, WA 99208-6289 | 2010-07-20 |
| 1154648814 | Providence Physician Services Co | Family Medicine | 212 E Central Ave, Ste 440, Spokane, WA 99208-6291 | 2010-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043787161 | Bonnie Rose Spencer | Social Worker | E 44 Cozza, Spokane, WA 99208 | 2018-10-26 |
| 1235617515 | Melissa Dawn Scholl | Massage Therapist | 906 E Country Hill Ct, Spokane, WA 99208 | 2018-07-30 |
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1467943720 | Simone Ferguson | Student in an Organized Health Care Education/Training Program | 7808 North Morton Avenue, Apt. # 675, Spokane, WA 99208 | 2018-05-22 |
| 1912496035 | Ascend Network Corp | Counselor | 3711 W Woodside, Spokane, WA 99208 | 2018-05-03 |
| 1023522216 | Cherrywood Place-spokane, LLC | Assisted Living Facility | 100 East Dalke Ave, Spokane, WA 99208 | 2017-11-27 |
| 1881118792 | Annie Kamau | Registered Nurse | 5920 W Lonewolf, Spokane, WA 99208 | 2017-08-01 |
| 1609303908 | Jeffery Anthony Glinski | Counselor | 3754 W. Indian Trail Rd., Spokane, WA 99208 | 2017-05-17 |
| 1487186938 | Mukhlis Azar | Physical Therapy Assistant | 305 E Sierra Ct, Spokane, WA 99208 | 2017-04-03 |
| 1154796241 | Daisy O'dell | Marriage & Family Therapist | 515 W. Francis Ave., Suite #8, Spokane, WA 99208 | 2015-12-01 |
| Find all providers in zip 99208 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215363676 | Lawrence Edward Klock Jr. | Internal Medicine | 4115 S Bellgrove Ln, Spokane, WA 99223-6185 | 2013-09-17 |
| 1649439209 | Allison A Lambert | Internal Medicine | 105 W 8th Ave Ste 660e, Spokane, WA 99204-2302 | 2008-06-08 |
| 1891737748 | Griffith E Liang | Internal Medicine | 105 W 8th Ave Ste 512c, Spokane, WA 99204-2318 | 2006-06-12 |
| 1437593175 | Angela Olson | Internal Medicine | 910 W 5th Ave Ste 1001, Spokane, WA 99204-2976 | 2013-04-24 |
| 1023374113 | Benjamin James Arthurs | Internal Medicine | 910 W 5th Ave Ste 1001, Spokane, WA 99204-2976 | 2012-04-03 |
| 1053618892 | Providence Physician Services Co | Internal Medicine | 105 W 8th Ave, Ste 550e, Spokane, WA 99204-2302 | 2011-02-14 |
| 1043535370 | Thomas Warren Decato | Internal Medicine | 212 E Central Ave Ste 315, Spokane, WA 99208 | 2010-03-30 |
| 1528126927 | Medical Specialists of Spokane Pllc | Internal Medicine | 104 W 5th Ave, Suite 400w, Spokane, WA 99204-4880 | 2006-12-05 |
| 1124136692 | North Spokane Pulmonary Clinic, P.s. | Internal Medicine | 212 E Central Ave, Suite 315, Spokane, WA 99208-6291 | 2006-08-26 |
| 1306836499 | Gregory M Loewen | Internal Medicine | 105 W 8th Ave, Suite 550, Spokane, WA 99204 | 2005-10-28 |
| Find all providers in SPOKANE | ||||
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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.