PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI# 1548571615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548571615 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES WASHINGTON |
| Other Organization Name | PROVIDENCE FAMILY MEDICINE EAST OLYMPIA |
| Practice Address |
525 Lilly Rd Ne Ste 250 Olympia WA 98506-5101 |
| Mailing Address |
Po Box 34439 Seattle WA 98124-1439 |
| Practice Telephone | 4255256694 |
| Mailing Telephone | 4255256778 |
| Mailing Fax Number | 4255256700 |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2011-02-01 |
| Authorized Official Name | DANIEL T HARRIS (CFO) |
| Authorized Official Telephone | 4256873603 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Family Medicine East Olympia | Other Name - Individual/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 |
525 LILLY RD NE STE 250 |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346290244 | Marina V Berndt | Family Medicine | 525 Lilly Rd Ne Ste 250, Pmg Sw Wa East Olympia Fam Med, Olympia, WA 98506-5101 | 2006-05-11 |
| 1831653179 | Susan Pilar Gresia | Social Worker | 525 Lilly Rd Ne Ste 250, Olympia, WA 98506-5101 | 2019-01-30 |
| 1386932580 | Elvira V Kadyrova | Family Medicine | 525 Lilly Rd Ne Ste 250, Pmg Sw Wa East Olympia Fam Med, Olympia, WA 98506-5101 | 2011-07-21 |
| 1457533366 | Paul M Knouff | Family Medicine | 525 Lilly Rd Ne Ste 250, Pmg Sw Wa East Olympia Fam Med, Olympia, WA 98506-5101 | 2007-12-03 |
| 1508055435 | Lynn Marie Okita | Nurse Practitioner | 525 Lilly Rd Ne Ste 250, Olympia, WA 98506 | 2007-10-16 |
| 1457420234 | Amy Beth Swadener | Nurse Practitioner | 525 Lilly Rd Ne Ste 250, Olympia, WA 98506-5101 | 2006-11-07 |
| 1366531329 | Stella S Thalhamer | Internal Medicine | 525 Lilly Rd Ne Ste 250, Olympia, WA 98506-5101 | 2006-10-11 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154974368 | Unruhly Medicine Pllc | Family Medicine | 1701 4th Ave E, Olympia, WA 98506-4533 | 2019-07-17 |
| 1104340405 | Sweet Medical Group, Pllc | Family Medicine | 8315 Normandy St Se, Olympia, WA 98504-0001 | 2017-07-28 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1285018432 | South Sound Medical Group, Pllc | Family Medicine | 10116 Coachman Ln Se, Olympia, WA 98501-9731 | 2015-07-17 |
| 1710378229 | Mary Gibbons | Family Medicine | 7040 Puget Beach Rd Ne, Olympia, WA 98516-9158 | 2015-02-05 |
| 1588095749 | Coral Hilby | Family Medicine | 2520 Island Dr Nw, Olympia, WA 98502-9749 | 2013-12-12 |
| 1053756999 | Anna Maria A. Pletz | Family Medicine | 525 Lilly Rd Ne # 250, Pmg Sw Wa East Olympia Fam Med, Olympia, WA 98506-5101 | 2013-05-06 |
| 1811330673 | Eugen Sine Enterprises Inc | Family Medicine | 2121 Stillwater Ave Nw, Olympia, WA 98507 | 2013-04-11 |
| 1972877736 | Eric Richard Houghton | Family Medicine | 1832 Lakewood Cir Se, Olympia, WA 98501-4291 | 2012-02-25 |
| 1073828976 | Lacambra Services Inc | Family Medicine | 7205 Martin Way E, Suite A-69, Olympia, WA 98516-5555 | 2010-08-16 |
| Find all providers in OLYMPIA | ||||
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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.