PACIFIC KIDNEY & HYPERTENSION, LLC (NPI# 1619460268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619460268 |
Entity Type | Organization |
Organization Name | PACIFIC KIDNEY & HYPERTENSION, LLC |
Other Organization Name | SNOHOMISH KIDNEY INSTITUTE |
Practice Address |
2707 Colby Ave Everett WA 98201-3528 |
Mailing Address |
1840 E Ray Rd Chandler AZ 85225-8720 |
Practice Telephone | 8553970197 |
Mailing Telephone | 8553970197 |
Enumeration Date | 2018-06-08 |
Last Update Date | 2019-11-26 |
Authorized Official Name | DR. ROBERT PROVENZANO (PHYSICIAN/OWNER) |
Authorized Official Telephone | 8553970197 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Snohomish Kidney Institute | Doing Business As Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
2707 Colby Ave, Everett, WA 982013528 | 8553970197 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679903231 | Pacific Kidney & Hypertension, LLC | Internal Medicine | 1547 Ne 40th Ave Ste B, Portland, OR 97232-1862 | 2013-11-19 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | PACIFIC KIDNEY & HYPERTENSION, LLC | 15895 Sw 72nd Avenue, Suite 250, Tigard, OR 97224 |
Street Address |
2707 COLBY AVE |
City | EVERETT |
State | WA |
Zip Code | 98201-3528 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306471867 | Shannon Michelle Dewald | Registered Nurse | D8s 1700 13th St, Everett, WA 98201 | 2020-03-05 |
1578123113 | Precious Medicial Spa, LLC | Registered Nurse | 1728 W. Marine View Dr Suite 212, Everett, WA 98201 | 2019-06-17 |
1508429796 | Alix Deschain | Counselor | 2801 Broadway, Everett, WA 98201 | 2019-04-15 |
1811457534 | Khushboo Patel | Pharmacist | 1330 Rockefeller Ave Ste 150, Everett, WA 98201 | 2019-03-20 |
1164991188 | Grace Talbot Davis | Registered Nurse | 2601 Summit Avenue, Bldg. C, Everett, WA 98201 | 2018-11-20 |
1063924603 | Tracy Sisk | Counselor | 3120 Colby Ave, 502, Everett, WA 98201 | 2017-11-03 |
1710403126 | Michelle Durham | Counselor | 3322 Boadway Fl 2, Everett, WA 98201 | 2017-08-17 |
1861927949 | Melanie Schmidt | Counselor | 2610 Westmore Ave, Everett, WA 98201 | 2017-04-26 |
1518413327 | Joseph Madson Dmd Pllc | Clinic/Center | 3802 Colby Ave, 4th Floor, Everett, WA 98201 | 2016-08-31 |
1043683162 | Jennifer Adams | Counselor | 1511 26th St, Everett, WA 98201 | 2015-11-11 |
Find all providers in zip 98201 |
Taxonomy Code | 207RN0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Nephrology |
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
---|---|---|---|---|
1417175811 | Western Washington Medical Group, Inc Ps | Internal Medicine | 1330 Rockefeller Ave Ste 450, Everett, WA 98201-1677 | 2007-04-23 |
1821015728 | Thao Truong Pascual | Internal Medicine | 2707 Colby Ave Ste 718, Everett, WA 98201-3528 | 2006-07-16 |
1750313151 | Ronald R. Reichel | Internal Medicine | 1111 Pacific Avenue, Suite B, Everett, WA 98201 | 2006-07-07 |
1003870023 | Timothy Edward Mcnamara | Internal Medicine | 1001 N Broadway, Suite A3, Everett, WA 98201-1586 | 2006-04-14 |
1407112337 | Katrina Carli | Internal Medicine | 2707 Colby Ave Ste 718, Everett, WA 98201-3528 | 2012-04-04 |
1518196542 | Noemie Corinne Juaire | Internal Medicine | 2707 Colby Ave Ste 718, Everett, WA 98201-3528 | 2009-07-12 |
1053592022 | C J Kuan Md Inc Ps | Internal Medicine | 3125 Colby Ave, Suite A, Everett, WA 98201-4032 | 2007-11-19 |
1952512329 | Hooman Hajian | Internal Medicine | 1111 Pacific Ave, Suite B, Everett, WA 98201-4200 | 2007-05-25 |
1952469314 | Paresh R Jadav | Internal Medicine | 3901 Hoyt Ave, Everett, WA 98201-4918 | 2006-12-05 |
1699885731 | Oliver Shu-on Tai | Internal Medicine | 2707 Colby Ave Ste 718, Everett, WA 98201-3528 | 2006-08-30 |
Find all providers in EVERETT |
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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.