PROVIDENCE HEALTHCARE


Address: 1015 E D St, Deer Park, WA 99006-5067
Phone: 5092321173

PROVIDENCE HEALTHCARE (NPI# 1720279953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720279953
Entity Type Organization
Organization Name PROVIDENCE HEALTHCARE
Other Organization Name DEER PARK HOSPITAL ER PHYSICIANS
Practice Address 1015 E D St
Deer Park
WA 99006-5067
Mailing Address 910 N Washington St
Suite 209
Spokane
WA 99201-2202
Practice Telephone 5092321173
Practice Fax Number 5092321165
Mailing Telephone 5092765061
Enumeration Date 2007-08-05
Last Update Date 2007-10-30
Authorized Official Name DEBBIE L WICKLUND (DIRECTOR OF FINANCE)
Authorized Official Telephone 5092321177
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 282NC0060X General Acute Care Hospital
Specialization: Critical Access
H 178 WA Hospitals

Other Provider Identifier

State Issuer Identifier Type Code
WA FACILITY ID 000015 01
WA 7086051 05
WA LICENSE H 178 01

Other Provider/Organization Names

Other Name Type Code
DEER PARK HOSPITAL ER PHYSICIANS Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1770856072 Providence Healthcare Home Health 8505 Nw 74th St, Suite B, Miami, FL 33166-2327 2012-02-16
1174692289 Providence Healthcare Assisted Living Facility 34 E 8th Ave, Spokane, WA 99202-7210 2006-11-06
1194917849 Providence Healthcare General Acute Care Hospital 101 W 8th Ave, Spokane, WA 99204-2307 2007-08-16
1215128277 Providence Healthcare General Acute Care Hospital 101 W 8th Ave, Spokane, WA 99204-2307 2007-08-06
1588855548 Providence Healthcare General Acute Care Hospital 500 E Webster Ave, Chewelah, WA 99109-9523 2007-08-06
1417148461 Providence Healthcare General Acute Care Hospital 1015 E D St, Deer Park, WA 99006-5067 2007-08-06
1225229289 Providence Healthcare General Acute Care Hospital 500 E Webster Ave, Chewelah, WA 99109-9523 2007-08-06
1952592917 Providence Healthcare General Acute Care Hospital 5633 N Lidgerwood St, Spokane, WA 99208-1224 2007-08-06
1861683823 Providence Healthcare General Acute Care Hospital 5633 N Lidgerwood St, Spokane, WA 99208-1224 2007-08-06
1497946453 Providence Healthcare General Acute Care Hospital 5633 N Lidgerwood St, Spokane, WA 99208-1224 2007-08-06

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Providence Healthcare LLC 4702 Ardley Drive, Colorado Springs, CO 80922
Oklahoma Business Registrations PROVIDENCE HEALTHCARE MANAGEMENT, LLC 202 S Main, Po Box 1009, Gore, OK 74435
System for Award Management (SAM) Entities PROVIDENCE HEALTHCARE OF MS, LLC 118 Levon Owens Dr, Terry, MS 39170-9696

Office Location

Street Address 1015 E D ST
City DEER PARK
State WA
Zip Code 99006-5067

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417148461 Providence Healthcare General Acute Care Hospital 1015 E D St, Deer Park, WA 99006-5067 2007-08-06

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1417572892 Deer Park Dental Pllc Dentist 118 E. Crawford St., Deer Park, WA 99006 2020-06-11
1124653464 James Phelan Optometrist 14 N. Vernon Ave., Deer Park, WA 99006 2020-03-06
1336628841 Shayla Michelle Simonson Massage Therapist West 114 South Avenue, Apt 4, Deer Park, WA 99006 2018-08-07
1710221494 Lori Tetsuro Mcdonald Hearing Instrument Specialist 23 E Crawford St, Suite D, Deer Park, WA 99006 2012-11-19
1952675076 Debra Kay Keller Pharmacist 412 S Main, Deer Park, WA 99006 2012-03-07
1457661027 Martha Joan Haney Massage Therapist W 110 Crawford, Suite J, Deer Park, WA 99006 2010-10-18
1487818324 Bi-mart Corporation Durable Medical Equipment & Medical Supplies 412 S. Main Avenue, Deer Park, WA 99006 2008-07-10
1912104498 Melissa Ann Mccollough Massage Therapist 20 East J Street Suite B, Deer Park, WA 99006 2007-06-28
1336368182 Community Health Association of Spokane Clinic/Center 401 S Main Street, Deer Park, WA 99006 2007-04-24
1215153739 Bates and Miller, Pllc, Dds Clinic/Center 20 E J Street, Suite 2b, Deer Park, WA 99006 2007-04-17
Find all providers in zip 99006

Taxonomy Information

Taxonomy Code 282NC0060X
Grouping Hospitals
Classification General Acute Care Hospital
Specialization Critical Access

Taxonomy Definition

Definition to come.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1396827424 Providence Health Care General Acute Care Hospital E 1015 'd' Street, Deer Park, WV 99006-0742 2006-10-19
1417057233 Providence Health Care General Acute Care Hospital 1015 East D Street, Deer Park, WA 99006-0742 2006-09-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1982157640 University of Washington General Acute Care Hospital 140 W Florentia St Apt C, Seattle, WA 98119-2393 2016-07-29
1396199824 Seattle Extracorporeal General Acute Care Hospital 925 Seneca Street, Seattle Extracorporeal, Seattle, WA 98101 2016-04-21
1487917233 Peacehealth Peace Island Medical Center General Acute Care Hospital 1117 Spring Street, Friday Harbor, WA 98250-7303 2012-06-18
1699914226 633 General Acute Care Hospital 7244 237th Ave Ne, Redmond, WA 98053-7914 2009-02-04
1447413091 Whidbey Island Public Hospital District General Acute Care Hospital 205 S Main Street, A, Coupeville, WA 98239 2008-07-03
1366609489 Public Hospital District No 1 of Mason County General Acute Care Hospital 901 Mt View Dr Bldg 1, Shelton, WA 98584-4401 2008-05-16
1508911645 Okanogan Douglas County Hospital Dist 1 General Acute Care Hospital 537 West Main, Brewster, WA 98812 2007-01-25
1801944038 Us Veterns Hospital Pharmacy General Acute Care Hospital 611 Sw 1st Ct, Battle Ground, WA 98604-8424 2007-01-05
1164512083 Grant County Public Hospital District #2 General Acute Care Hospital 908 Tenth Avenue Sw, Quincy, WA 98848 2006-10-13
1255429957 Garfield County Memorial Hospital District General Acute Care Hospital 66 North 6th Street, Pomeroy, WA 99347-9705 2006-10-10
Find all providers with the same taxonomy

Competitor

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City DEER PARK
Zip Code 99006

Improve Information

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Dataset Information

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.

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