DR. PHILIP D. FELICIANO (NPI# 1457338451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457338451 |
| Entity Type | Individual |
| Full Name | DR. PHILIP D. FELICIANO |
| Credential | MD |
| Practice Address |
1321 Colby Avenue Providence Everett Medical Center Everett WA 98206 |
| Mailing Address |
201 16th Ave E Seattle WA 98112-5226 |
| Practice Telephone | 4252612000 |
| Mailing Telephone | 2063263000 |
| Mailing Fax Number | 2063262785 |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2020-01-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD00014810 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I PROVIDER NUMBER | 177308 | 01 |
| WA | 8309874 | 05 |
| Street Address |
1321 COLBY AVENUE PROVIDENCE EVERETT MEDICAL CENTER |
| City | EVERETT |
| State | WA |
| Zip Code | 98206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245290592 | Martin John Pointon | Pathology | 1321 Colby Avenue, Everett, WA 98206 | 2006-03-23 |
| 1063481570 | Cellnetix Labs LLC | Clinical Medical Laboratory | 1321 Colby Avenue, Everett, WA 98206 | 2006-03-16 |
| 1356310866 | Cellnetix Pathology Pllc | Pathology | 1321 Colby Avenue, Everett, WA 98206 | 2006-03-16 |
| 1124097233 | Barry Todd Kahn | Pathology | 1321 Colby Avenue, Everett, WA 98206 | 2006-03-14 |
| 1679541080 | Lawrence Edwin Preshaw | Pathology | 1321 Colby Avenue, Everett, WA 98206 | 2006-03-10 |
| 1437137999 | G. Thomas Ruebel | Radiology | 1321 Colby Avenue, Providence Everett Medical Center, Everett, WA 98206 | 2006-01-05 |
| 1639157191 | Donald R. Peters | Radiology | 1321 Colby Avenue, Providence Everett Medical Center, Everett, WA 98206 | 2006-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649308867 | Menaka Charan | Specialist | 916 Pacific Ave, Everett, WA 98206 | 2007-03-01 |
| 1215915723 | Nancy Jane Neubauer | Radiology | 1321 Colby Ave, Providence Everett Medical Center, Everett, WA 98206 | 2006-01-04 |
| 1174932651 | Chase Hillock | Counselor | 2802 Lombard Avenue, Everett, WA 98206-0839 | 2014-08-08 |
| 1821132853 | Carolyn Wilson Luck | Physical Therapist | 916 Pacific Ave., Everett, WA 98206-1067 | 2007-02-15 |
| 1134223878 | Providence Everett Medical Center | Rehabilitation Unit | 916 Pacific Avenue, Everett, WA 98206-1067 | 2006-09-12 |
| 1174663058 | Rosemary Huehnergarth | Physical Therapy Assistant | 1321 Colby Ave., Providence Medical Center, Everett, WA 98206-1147 | 2007-02-08 |
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497975361 | Rolando I Celis Valdiviezo | Surgery | 1330 Rockefeller Ave Ste 520, Everett, WA 98201 | 2007-04-26 |
| 1396894879 | Anthony J. Roon | Surgery | 1001 N Broadway Ste A3, Everett, WA 98201-1585 | 2007-01-10 |
| 1184664625 | David E Mullane | Surgery | 512 Broadway, Suite 2, Everett, MA 02149-3738 | 2006-06-06 |
| 1720066616 | William Burley Mcintyre | Surgery | 1321 Colby Ave, Providence Everett Medical Center, Everett, WA 98201-1665 | 2006-01-03 |
| 1649257692 | Robert D. Defrang | Surgery | 1330 Rockefeller Ave, Ste 520, Everett, WA 98201-1684 | 2005-12-29 |
| 1255318317 | James M. Cook Jr. | Surgery | 1330 Rockefeller Ave, Ste 520, Everett, WA 98201-1684 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496922 | Sunnyside Community Hospital Association | Surgery | 1005 W Walnut St Ste 201, Yakima, WA 98902-3384 | 2017-09-20 |
| 1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
| 1356722938 | Usa Vascular Centers of Kent Pllc | Surgery | 26124a Pacific Hwy S Ste A, Kent, WA 98032-6910 | 2015-06-09 |
| 1154602084 | Memorial Physicians, Pllc | Surgery | 1812 E Edison Ave, Sunnyside, WA 98944-1653 | 2011-09-06 |
| 1528387941 | Sara Jane Wasilenko | Surgery | 128 Lilly Rd Ne Ste 205, Olympia, WA 98506-7400 | 2010-05-25 |
| 1801051404 | Franciscan Medical Group | Surgery | 710 S 348th St, Ste A, Federal Way, WA 98003-7042 | 2008-07-23 |
| 1013104165 | John S Arthur | Surgery | 2528 Wheaton Way Ste 101, Bremerton, WA 98310-3305 | 2007-10-02 |
| 1891986097 | Vascular Associates, Ps | Surgery | 801 Broadway Ste 522, Seattle, WA 98122-4325 | 2007-08-05 |
| 1447464730 | Mai Thanh Pham | Surgery | 1229 Madison St Suite # 1190, Seattle, WA 98104 | 2007-05-09 |
| 1649491481 | Dae Young Lee | Surgery | 1100 Goethals Drive 3rd Floor, Kadlec Clinic Vascular Surgery, Richland, WA 99352-3304 | 2007-05-01 |
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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.