PROVIDENCE HEALTH & SERVICES - WA (NPI# 1669616363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669616363 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WA |
| Other Organization Name | PROVIDENCE PHYSICIAN GROUP HARBOUR POINTE CARDIOLOGY |
| Practice Address |
4112 Harbour Pointe Blvd Sw Suite 100 Mukilteo WA 98275-5457 |
| Mailing Address |
Po Box 34439 Seattle WA 98124-1439 |
| Practice Telephone | 4253476330 |
| Practice Fax Number | 4253476335 |
| Mailing Telephone | 4255256652 |
| Mailing Fax Number | 4255256700 |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2010-12-27 |
| Authorized Official Name | NICHOLE QUINN (PAYOR CREDENTIALING MANAGER) |
| Authorized Official Telephone | 4255256715 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Physician Group Harbour Pointe Cardiology | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215189808 | Providence Health & Services - Wa | Home Health | 1000 N Argonne Rd, Spokane Valley, WA 99212 | 2008-10-15 |
| 1750783759 | Providence Health & Services - Wa | Pharmacy | 916 Pacific Ave, Everett, WA 98201-4147 | 2014-09-22 |
| 1972927267 | Providence Health & Services - Wa | Emergency Response System Companies | 2731 Wetmore Ave, Suite 500, Everett, WA 98201-3571 | 2014-02-07 |
| 1770877227 | Providence Health & Services - Wa | General Practice | 1830 Bickford Ave, Suite 211, Snohomish, WA 98290-1749 | 2011-06-01 |
| 1639468259 | Providence Health & Services - Wa | Orthopaedic Surgery | 1717 13th St, Suite 401, Everett, WA 98201-1621 | 2011-04-05 |
| 1225335425 | Providence Health & Services - Wa | Surgery | 1330 Rockefeller Ave, Ste 520, Everett, WA 98201-1684 | 2011-02-24 |
| 1649402231 | Providence Health & Services - Wa | Social Worker | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2009-08-14 |
| 1861622557 | Providence Health & Services - Wa | Social Worker | 12800 Bothell Everett Hwy, Suite 110, Everett, WA 98208-6642 | 2009-07-16 |
| 1265669451 | Providence Health & Services - Wa | Clinic/Center | 101 W 8th Ave, Women's Health Center, Spokane, WA 99204-2307 | 2009-06-16 |
| 1003050709 | Providence Health & Services - Wa | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite100, Mukilteo, WA 98275-5457 | 2009-04-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
4112 HARBOUR POINTE BLVD SW SUITE 100 |
| City | MUKILTEO |
| State | WA |
| Zip Code | 98275-5457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760474738 | Chiyang Wu | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2005-08-16 |
| 1144662008 | Rolana O Mesias | Registered Nurse | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2013-07-20 |
| 1467728964 | Sabrina Middleton | Pediatrics | 4112 Harbour Pointe Blvd Sw, Ste 100, Mukilteo, WA 98275-5457 | 2012-03-29 |
| 1639481500 | Dean Nair | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2010-07-08 |
| 1003050709 | Providence Health & Services - Wa | Family Medicine | 4112 Harbour Pointe Blvd Sw, Suite100, Mukilteo, WA 98275-5457 | 2009-04-24 |
| 1124279237 | Providence Health & Services - Wa | Internal Medicine | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2008-10-07 |
| 1700037199 | Providence Health & Services-wa | Clinic/Center | 4112 Harbour Pointe Blvd Sw, Suite 100, Mukilteo, WA 98275-5457 | 2008-10-04 |
| 1366602468 | Poonam Rauniyar | Pediatrics | 4112 Harbour Pointe Blvd Sw, Ste 100, Mukilteo, WA 98275-5457 | 2008-06-11 |
| 1568644607 | Rajasri Dharani Palepu | Internal Medicine | 4112 Harbour Pointe Blvd Sw, Mukilteo, WA 98275-5457 | 2007-11-30 |
| 1225111867 | Darrell Eugene Cline | Dentist | 4112 Harbour Pointe Blvd Sw, Suite 200, Mukilteo, WA 98275 | 2006-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477030245 | Brandon Eugene Moore | Social Worker | 12303 Cyrus Way, Suite 107, Mukilteo, WA 98275 | 2018-07-25 |
| 1407349962 | Cascade Endocrinology Pllc | Internal Medicine | 8423 Mukilteo Spdwy Ste 102, Mukilteo, WA 98275 | 2018-06-10 |
| 1780059899 | Jamie Kowatch | Dietitian, Registered | 8423 Mukilteo Speedway Ste 102, Mukilteo, WA 98275 | 2015-12-01 |
| 1225479025 | Helen Ra | Pharmacist | 5600 Harbour Pointe Blvd., Unit 1-105, Mukilteo, WA 98275 | 2013-07-10 |
| 1861731333 | Lynn Sharon Schmidt | Physical Therapist | 10520 Harbour Pointe Blvd, Columbia Elementary School - Msd #6, Mukilteo, WA 98275 | 2013-02-04 |
| 1023318326 | Hillary E Hofstaedter | Registered Nurse | 10710 Mukilteo Speedway # 67, Mukilteo, WA 98275 | 2010-11-02 |
| 1528371416 | Zita Molnar Fekete | Counselor | 4460 73rd Pl Sw, Mukilteo, WA 98275 | 2010-07-20 |
| 1497900609 | Heidi S. Rendall | Family Medicine | 8227 44th Ave W., Ste E, Mukilteo, WA 98275 | 2008-12-02 |
| 1558583609 | Ana B Rountree | Physician Assistant | 10710 Mukilteo Spdwy, Mukilteo, WA 98275 | 2007-05-02 |
| 1376769752 | Wahid Elbahr | Dentist | 12121 Harbour Reach Dr., Ste 210, Mukilteo, WA 98275 | 2007-04-17 |
| Find all providers in zip 98275 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1255844163 | Shc Medical Center - Yakima | Internal Medicine | 1005 W Walnut St Ste 120, Yakima, WA 98902-3360 | 2017-11-14 |
| 1295113108 | Sophia Larson | Internal Medicine | 1959 Ne Pacific St Ste Bb-552, Seattle, WA 98195 | 2015-05-12 |
| 1780002485 | Kavisha Singh | Internal Medicine | 62 W 7th Ave Ste 450, Spokane, WA 99204-2321 | 2014-04-01 |
| 1740522127 | Takor Besong Arrey-mbi | Internal Medicine | Madigan Army Medicalcenter 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2013-03-22 |
| 1023357845 | Samuel Everett George | Internal Medicine | 19005 Se 34th St Bldg 3, Vancouver, WA 98683 | 2013-02-14 |
| 1386997740 | Fredric Tobis | Internal Medicine | 7411 Se 36th St, Mercer Island, WA 98040-3412 | 2012-10-23 |
| 1063716595 | Jeffrey David Feldstein | Internal Medicine | 5415 Ne 52nd St, Vancouver, WA 98661-7838 | 2010-12-23 |
| 1407162571 | Providence Health & Services - Washington | Internal Medicine | 510 E Amende Drive, Odessa, WA 99159-0000 | 2010-08-26 |
| 1881907715 | Providence Health & Services Washington | Internal Medicine | 62 W 7th Ave, Spokane, WA 99204-2321 | 2010-07-20 |
| 1720391659 | Providence Health & Services | Internal Medicine | 629 Jasmine St, Omak, WA 98841 | 2010-07-20 |
| 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.