PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI# 1598750895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598750895 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES WASHINGTON |
| Other Organization Name | PROVIDENCE MARIANWOOD |
| Practice Address |
3725 Providence Point Dr Se Issaquah WA 98029-7219 |
| Mailing Address |
Po Box 94582 Seattle WA 98124-6882 |
| Practice Telephone | 4253912800 |
| Practice Fax Number | 4253915440 |
| Mailing Telephone | 4253912800 |
| Mailing Fax Number | 4253915440 |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2019-02-15 |
| Authorized Official Name | DONALD WAYNE ANDERSON JR. (DIR REIMB ADMIN & ASST SEC ENROLLMT) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 1177 | WA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1177 | 05 |
| Other Name | Type Code |
|---|---|
| Providence Marianwood | 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 |
3725 PROVIDENCE POINT DR SE |
| City | ISSAQUAH |
| State | WA |
| Zip Code | 98029-7219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326204264 | Barbara Ann Schaefer | Community Health Worker | 3725 Providence Point Dr Se, Issaquah, WA 98029-7219 | 2008-07-30 |
| 1851557797 | Joan Fargo | Community Health Worker | 3725 Providence Point Dr Se, Issaquah, WA 98029-7219 | 2008-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134730161 | Katelyn Creech | Counselor | 1505 16th Lane Ne, Apt 404 Building O, Issaquah, WA 98029 | 2020-08-13 |
| 1326695438 | M Shoaib Haider Siddiqui | Dentist | Issaquah Modern Dentistry, 1416 Highlands Drie Ne, Suite 120, Issaquah, WA 98029 | 2019-08-22 |
| 1053885061 | Rose Osborne | Registered Nurse | 4580 Klahanie Dr Se #181, Sammamish, WA 98029 | 2019-01-14 |
| 1598260960 | Caryn Crosbie | Behavior Technician | 22526 Se 64th Place, Building D Suite 210, Issaquah, WA 98029 | 2018-03-28 |
| 1194110908 | May Y. Mar | Family Medicine | 5708 E. Lake Sammamish Pkwy Se, Issaquah, WA 98029 | 2015-03-30 |
| 1659765816 | Eastside Social Skills Therapy LLC | Preferred Provider Organization | 5436 232nd Ave Se, Issaquah, WA 98029 | 2015-03-26 |
| 1649513946 | Linda Scoppettone Knodel | Registered Nurse | 5303 231 Ave. Se, Issaquah, WA 98029 | 2013-04-04 |
| 1720323116 | Morley Slutsky | Preventive Medicine | 4580 Klahanie Dr. S.e.,#125, Issaquah, WA 98029 | 2012-12-11 |
| 1619248820 | Silas Dickenson Dudley | Dentist | 2520 Ne Park Dr, Suite C, Issaquah, WA 98029 | 2012-01-19 |
| 1659641678 | Cynthia J Creel | Technician/Technologist | 4580 Klahanie Dr. Se, #332, Issaquah, WA 98029 | 2012-01-06 |
| Find all providers in zip 98029 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518150663 | Lcs-westminster Partnership IIi LLP | Skilled Nursing Facility | 100 Timber Ridge Way Nw, Issaquah, WA 98027-8890 | 2007-08-22 |
| 1992700249 | Bouchy, LLC | Skilled Nursing Facility | 805 Front St S, Issaquah, WA 98027-4205 | 2005-06-14 |
| 1629265871 | Northwest Care-issaquah, Inc. | Skilled Nursing Facility | 805 Front St S, Issaquah, WA 98027-4205 | 2007-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821639717 | Atsugi LLC | Skilled Nursing Facility | 23815 Se 28th St, Sammamish, WA 98075 | 2019-10-02 |
| 1457840795 | Mission Healthcare At Renton, LLC | Skilled Nursing Facility | 17420 106th Pl Se, Renton, WA 98055-5438 | 2018-05-02 |
| 1104330349 | North Auburn Health, LLC | Skilled Nursing Facility | 2830 I Street Ne, Auburn, WA 98002 | 2017-11-27 |
| 1831603075 | Fir Lane Health-shelton,llc | Skilled Nursing Facility | 2430 North 13th St, Shelton, WA 98584 | 2017-11-27 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1215455365 | Thirty Three Oaks, LLC | Skilled Nursing Facility | 400 E. 33rd St., Vancouver, WA 98663 | 2017-09-08 |
| 1730607953 | Aurora Oaks, LLC | Skilled Nursing Facility | 16357 Aurora Avenue North, Shoreline, WA 98133 | 2017-09-08 |
| 1265950422 | University Place Rehabilitation Center, LLC | Skilled Nursing Facility | 5520 Bridgeport Way W., University Place, WA 98467 | 2017-09-07 |
| 1235662081 | Alexandra Vick | Skilled Nursing Facility | 18621 29th Ave E, Tacoma, WA 98445-4323 | 2017-04-08 |
| 1255883831 | Heron's Key | Skilled Nursing Facility | 4340 Borgen Blvd, Gig Harbor, WA 98332-7000 | 2016-10-28 |
| 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.