PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1417124488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417124488 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Practice Address |
820 S Mcclellan St Ste 300b Spokane WA 99204-2246 |
| Mailing Address |
101 W 8th Ave Mother Gamelin Center, 3rd Floor Spokane WA 99204-2307 |
| Practice Telephone | 5094647880 |
| Practice Fax Number | 5098380721 |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2011-02-28 |
| Authorized Official Name | SEAN M DOUGLAS (CFO) |
| Authorized Official Telephone | 5094742225 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
600503827 | WA | Allopathic & Osteopathic Physicians |
| 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 |
820 S MCCLELLAN ST STE 300B |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588662530 | Lisa Bess Christian | Psychologist | 820 S Mcclellan St, Spokane, WA 99204-2457 | 2005-07-13 |
| 1568907244 | Mark Ingoldby | Social Worker | 820 S Mcclellan St, Suite 200, Spokane, WA 99204-2457 | 2017-01-04 |
| 1386006427 | Elizabeth Marie Gilroy | Registered Nurse | 820 S Mcclellan St, Spokane, WA 99204-2457 | 2016-03-28 |
| 1144652652 | Gargi Ganguly | Internal Medicine | 820 S Mcclellan St, Suite 500, Spokane, WA 99204-2457 | 2013-08-07 |
| 1124462478 | Caitlin Jane Allen | Internal Medicine | 820 S Mcclellan St, Suite 500, Spokane, WA 99204-2457 | 2013-04-17 |
| 1538464060 | Kaushik Chatterjee | Internal Medicine | 820 S Mcclellan St, Suite 200, Spokane, WA 99204-2457 | 2011-01-13 |
| 1659689768 | Vincint L. Sprung | Physician Assistant | 820 S Mcclellan St, Suite 300, Spokane, WA 99204-2457 | 2010-09-23 |
| 1609193374 | Providence Physician Services Co | Orthopaedic Surgery | 820 S Mcclellan St, Ste 300, Spokane, WA 99204-2457 | 2010-04-21 |
| 1952636672 | Cameron Chesnut | Dermatology | 820 S Mcclellan St, Suite 426, Spokane, WA 99204-2457 | 2009-10-14 |
| 1578712923 | Danny Lee Jones II | Physician Assistant | 820 S Mcclellan St, Suite 300, Spokane, WA 99204-2457 | 2008-09-10 |
| 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 | 207XX0801X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Trauma |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407039555 | Valley Orthopedic Clinic, P.s. | Orthopaedic Surgery | 12525 E Mission Ave, Ste 107, Spokane Valley, WA 99216-1063 | 2007-12-12 |
| 1790172880 | Krystin Hidden | Orthopaedic Surgery | 325 9th Ave, Seattle, WA 98104-2420 | 2015-04-16 |
| 1285049890 | D'ann Arthur | Orthopaedic Surgery | 325 9th Ave, Seattle, WA 98104-2420 | 2014-06-23 |
| 1083050843 | Jonah Hebert-davies | Orthopaedic Surgery | 325 9th Ave, Seattle, WA 98104-2420 | 2013-05-20 |
| 1063738532 | Michael F Githens | Orthopaedic Surgery | 325 9th Ave, Seattle, WA 98104-2420 | 2010-04-08 |
| 1003935388 | Tamara Shannan Simpson | Orthopaedic Surgery | 512 N Young St, Suite C, Kennewick, WA 99336-7806 | 2007-03-28 |
| 1013059070 | Sean E Nork | Orthopaedic Surgery | 325 9th Ave, Seattle, WA 98104 | 2007-02-13 |
| 1790861599 | Daphne Michelle Beingessner | Orthopaedic Surgery | Harborview Medical Center, 325 9th Ave, Seattle, WA 98104 | 2006-10-27 |
| 1538138268 | Eric Geoffrey Puttler | Orthopaedic Surgery | 3801 5th St Se, Suite 110, Puyallup, WA 98374 | 2006-03-15 |
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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.