PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI# 1407055759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407055759 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES WASHINGTON |
| Other Organization Name | PROVIDENCE ST PETER HOSPITAL |
| Practice Address |
410 Providence Ln. Building 2 Olympia WA 98506-5101 |
| Mailing Address |
Po Box 3505 Portland OR 97208-3505 |
| Practice Telephone | 3604937451 |
| Practice Fax Number | 3604937977 |
| Mailing Telephone | 4255256778 |
| Mailing Fax Number | 4255256700 |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2017-10-30 |
| Authorized Official Name | DONALD WAYNE ANDERSON JR. (DIRECTOR REIMBURSEMENT ADMINISTRATI) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | 000080 | WA | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 7037336 | 05 | |
| WA | L&I CRIME VICTIMS | 8901337 | 01 |
| WA | L&I | 129210 | 01 |
| Other Name | Type Code |
|---|---|
| Providence St Peter Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134656135 | Providence Health & Services Washington | Clinic/Center | 1018 Capitol Way S Ste 300, Olympia, WA 98501-1212 | 2017-05-22 |
| 1023550050 | Providence Health & Services Washington | Psychologist | 225 State Ave Ne, Olympia, WA 98501-6951 | 2016-11-08 |
| 1003367863 | Providence Health & Services Washington | Radiology | 4800 College St Se Ste E, Lacey, WA 98503-4389 | 2016-10-17 |
| 1023563897 | Providence Health & Services Washington | Clinic/Center | 1705 Se Meadowbrook Blvd, Suite 2, College Place, WA 99324-1756 | 2016-08-22 |
| 1457721250 | Providence Health & Services Washington | Clinic/Center | 1200 Basich Blvd, Aberdeen, WA 98520-1035 | 2015-10-06 |
| 1902141500 | Providence Health & Services Washington | Clinical Medical Laboratory | 820 S Mcclellan St Ste Ll10, Spokane, WA 99204-2446 | 2012-12-07 |
| 1881907715 | Providence Health & Services Washington | Internal Medicine | 62 W 7th Ave, Spokane, WA 99204-2321 | 2010-07-20 |
| 1073744850 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 2505 Olympic Hwy N., Ste 140, Shelton, WA 98584-2978 | 2009-07-28 |
| 1770714693 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 508 1/2 Eighth Street, Hoquiam, WA 98550-3521 | 2009-07-28 |
| 1033309604 | Providence Health & Services Washington | Family Medicine | 1450 Northwest Lane Se, Lacey, WA 98503-6908 | 2007-07-30 |
| Street Address |
410 PROVIDENCE LN. BUILDING 2 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407964133 | Providence Health & Services Washington | Rehabilitation Unit | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437575982 | Suzette Gurtisen, Lmp | Rehabilitation Unit | 4763 Poppy St, West Richland, WA 99353-7770 | 2014-03-07 |
| 1225230980 | Columbia Basin Physical Therapy Inc. Ps | Rehabilitation Unit | 1075 Basin St Sw, Ephrata, WA 98823-2041 | 2007-06-04 |
| 1083672273 | Peacehealth | Rehabilitation Unit | 809 E Chestnut St, Bellingham, WA 98225-5221 | 2006-05-04 |
| 1972507580 | Kadlec Regional Medical Center | Rehabilitation Unit | 888 Swift Blvd, Richland, WA 99352 | 2005-06-10 |
| 1790319580 | Kadlec Regional Medical Center | Rehabilitation Unit | 888 Swift Blvd, Richland, WA 99352-3514 | 2020-03-02 |
| 1548734205 | Peacehealth Southwest Medical Center | Rehabilitation Unit | 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 | 2019-01-16 |
| 1861995714 | Peacehealth United General Medical Center | Rehabilitation Unit | 2000 Hospital Dr, Sedro Woolley, WA 98284-4327 | 2018-03-16 |
| 1437677671 | Shc Medical Center - Yakima | Rehabilitation Unit | 110 S 9th Ave, Yakima, WA 98902-3315 | 2017-09-08 |
| 1558601195 | Seattle Spine and Rehabilitation | Rehabilitation Unit | 3213 Eastlake Ave E, Seattle, WA 98102-7127 | 2013-02-19 |
| 1750627089 | Wenatchee Valley Hospital | Rehabilitation Unit | 820 N Chelan Ave, Wenatchee, WA 98801-2028 | 2012-12-13 |
| 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.