PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1407162571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407162571 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Other Organization Name | PROVIDENCE SPOKANE HEART INSTITUTE |
| Practice Address |
510 E Amende Drive Odessa WA 99159-0000 |
| Mailing Address |
122 W 7th Ave Spokane WA 99204-2349 |
| Practice Telephone | 5099822614 |
| Mailing Telephone | 5098387711 |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2010-08-26 |
| Authorized Official Name | RANDEE REID (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 4255256694 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Spokane Heart Institute | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841503034 | Providence Health & Services - Washington | Family Medicine | 18313 Paulsonst Sw, Suite A, Rochester, WA 98579-9262 | 2010-07-16 |
| 1083947709 | Providence Health & Services - Washington | Hospice Care, Community Based | 2731 Wetmore Ave Ste 500, Everett, WA 98201-3585 | 2009-09-14 |
| 1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
| 1558512368 | Providence Health & Services - Washington | Home Health | 209 W Poplar St, Walla Walla, WA 99362 | 2008-10-10 |
| 1922259738 | Providence Health & Services - Washington | Internal Medicine | 380 Chase Avenue, Pmg Se Wa, Walla Walla, WA 99362-2924 | 2008-10-10 |
| 1306097126 | Providence Health & Services - Washington | Radiology | 401 W Poplar Street, Pmg Se Wa Imaging, Walla Walla, WA 99362-2846 | 2008-10-10 |
| 1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
| 1073677605 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 506 W Franklin St, Shelton, WA 98584-3517 | 2006-12-20 |
| 1003906918 | Providence Health & Services - Washington | Home Health | 3432 Bay Rd Ne, Olympia, WA 98506-2958 | 2006-10-13 |
| 1376638171 | Providence Health & Services - Washington | Skilled Nursing Facility | 4900 Eagle St, Anchorage, AK 99503-7446 | 2006-10-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
510 E AMENDE DRIVE |
| City | ODESSA |
| State | WA |
| Zip Code | 99159-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831683168 | Gregg Liedtka Dmd Pllc | Dentist | 20 W 1st Ave, Odessa, WA 99159 | 2018-06-20 |
| 1891845046 | Troy D. Eldridge Sr. | Chiropractor | 18 W. 1st Avenue, Odessa, WA 99159 | 2007-01-11 |
| 1780746859 | Marlene K Brendell | Family Medicine | 510 E. Amende, Odessa, WA 99159 | 2006-12-15 |
| 1023122520 | Lincoln County Public Hospital District 1 | Clinic/Center | 510 E Amende, Odessa, WA 99159 | 2006-08-19 |
| 1114031614 | Lincoln County Public Hospital District 1 | Assisted Living Facility | 506 E. Amende, Odessa, WA 99159 | 2006-08-19 |
| 1639283971 | Lincoln County Public Hospital District 1 | General Acute Care Hospital | E. 502 Amende, Odessa, WA 99159 | 2006-08-17 |
| 1245343193 | Lincoln County Public Hospital District 1 | Ambulance | 502 E Amende, Odessa, WA 99159 | 2006-08-16 |
| 1073524690 | Lincoln County Public Hospital District 1 | General Acute Care Hospital | 502 E. Amende, Odessa, WA 99159 | 2006-08-10 |
| 1699977561 | Eldridge Chiropractic Ps | Chiropractor | 18 W. 1st Avenue, Odessa, WA 99159 | 2007-06-04 |
| 1740317544 | Lincoln County Public Hospital District 1 | Family Medicine | 510 E. Amende, Odessa, WA 99159 | 2007-02-27 |
| Find all providers in zip 99159 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1477814028 | West Texas Cardiology Pa | Internal Medicine | 501 Golder Ave Ste 203a, Odessa, TX 79761-4440 | 2012-05-30 |
| 1336423169 | Raja Naidu Md Pa | Internal Medicine | 605 E. 4th St, Suite 203, Odessa, TX 79761-5100 | 2011-09-28 |
| 1861784399 | Adam Jeffery Farber | Internal Medicine | 540 W 5th St Ste 460, Odessa, TX 79761 | 2011-05-03 |
| 1346478013 | Cardiovascular Specialists of Texas, P.a. | Internal Medicine | 605 E. 4th St., Suite 200, Odessa, TX 79761-5100 | 2009-07-01 |
| 1972516516 | Pankaj V. Patel, M.d.,p.a. | Internal Medicine | 540 W 5th St Ste 310, Odessa, TX 79761-5062 | 2006-08-14 |
| 1528065893 | Ramachandra Kolluru | Internal Medicine | 420e6th Street, Odessa, TX 79761-4537 | 2005-07-01 |
| 1427050780 | Suresh N Gadasalli M D P A | Internal Medicine | 500 E 4th St, Odessa, TX 79761-5110 | 2005-06-01 |
| 1992127195 | Arrhythmia Consultants of Texas Pa | Internal Medicine | 420 E 6th St, Suite 201b, Odessa, TX 79761-4529 | 2014-01-08 |
| 1578854436 | Cardiovascular Specialists of Texas, P.a | Internal Medicine | 315 Golder Ave, Suite B, Odessa, TX 79761-5043 | 2011-04-27 |
| 1679721013 | Texas Cardiovascular Consultants, Pa | Internal Medicine | 605 E 4th St, Ste. 200, Odessa, TX 79761-5100 | 2008-08-27 |
| Find all providers in ODESSA | ||||
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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.