PROVIDENCE HEALTH & SERVICES-WA (NPI# 1831499755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831499755 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES-WA |
| Other Organization Name | PROVIDENCE PHYSICIAN GROUP- NEUROSURGERY AND SPINE CLINIC |
| Practice Address |
1330 Rockefeller Ave Suite 225 Everett WA 98201-1684 |
| Mailing Address |
Po Box 34439 Seattle WA 98124-1439 |
| Practice Telephone | 4252614960 |
| Practice Fax Number | 4252251001 |
| Mailing Telephone | 4255256652 |
| Mailing Fax Number | 4255256700 |
| Enumeration Date | 2010-10-26 |
| 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 |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Physician Group- Neurosurgery and Spine Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114236791 | Providence Health & Services-wa | Surgery | 1330 Rockefeller Avenue, Suite 400, Everett, WA 98201-1676 | 2010-09-30 |
| 1588294854 | Providence Health & Services-wa | Clinic/Center | 916 Pacific Ave, Everett, WA 98201-4147 | 2020-01-24 |
| 1649615220 | Providence Health & Services-wa | Naturopath | 1321 Colby Ave, Everett, WA 98201-1665 | 2013-05-08 |
| 1215225099 | Providence Health & Services-wa | Midwife | 14692 179th Ave Se, Ste 800, Monroe, WA 98272-1162 | 2011-07-14 |
| 1447547658 | Providence Health & Services-wa | Registered Nurse | 14692 179th Ave Se, Ste 800, Monroe, WA 98272-1162 | 2011-07-08 |
| 1891088845 | Providence Health & Services-wa | Pharmacy | 3305 Nassau St # 101, Everett, WA 98201-4140 | 2011-05-24 |
| 1972819175 | Providence Health & Services-wa | Registered Nurse | 3305 Nassau St, Everett, WA 98201-4140 | 2010-08-25 |
| 1164747242 | Providence Health & Services-wa | General Practice | 1717 13th Street, Everett, WA 98201-1621 | 2010-04-01 |
| 1346571841 | Providence Health & Services-wa | Nurse Practitioner | 1330 Rockefeller, Suite 200, Everett, WA 98201-1677 | 2010-01-22 |
| 1255664652 | Providence Health & Services-wa | Obstetrics & Gynecology | 900 Pacific Ave, Suite 501, Everett, WA 98201-4147 | 2009-09-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Providence Health & Services-Washington | 1801 Lind Ave Sw #9016, Renton, Washington 98057-9016 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES-WASHINGTON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES-WASHINGTON | 1801 Lind Ave Sw #9016, Renton, WA 98057-3368 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES-WASHINGTON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
| Street Address |
1330 ROCKEFELLER AVE SUITE 225 |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-1684 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366435943 | John F Matista | Physician Assistant | 1330 Rockefeller Ave, Suite 225, Everett, WA 98201-1684 | 2005-08-29 |
| 1326598715 | Providence Regional Medical Center | Clinic/Center | 1330 Rockefeller Ave, Suite 150 Medical Offfic Building, Everett, WA 98201-1684 | 2016-10-10 |
| 1861940504 | Lindsay Cook Mertz | Physician Assistant | 1330 Rockefeller Ave, Suite 310, Everett, WA 98201-1684 | 2016-09-12 |
| 1437524352 | John Gavareski | Physician Assistant | 1330 Rockefeller Ave, Everett, WA 98201-1684 | 2015-12-03 |
| 1700261120 | Anna Chan | Pharmacist | 1330 Rockefeller Ave, Suite 150, Everett, WA 98201-1684 | 2015-07-27 |
| 1588051494 | Luis Fernando Alberton | Surgery | 1330 Rockefeller Ave, Ste 400, Everett, WA 98201-1684 | 2015-04-17 |
| 1205222551 | Patrick Willauer | Surgery | 1330 Rockefeller Ave, Everett, WA 98201-1684 | 2015-04-14 |
| 1538554761 | Patrick M Haugstad | Pharmacist | 1330 Rockefeller Ave, Suite 150, Everett, WA 98201-1684 | 2015-04-03 |
| 1770972481 | Lisa Mccabe | Nurse Practitioner | 1330 Rockefeller Ave, Suite 310, Everett, WA 98201-1684 | 2015-01-19 |
| 1851798714 | Emily Rockwell Williamson | Pharmacist | 1330 Rockefeller Ave, Suite 150, Everett, WA 98201 | 2014-11-20 |
| Find all providers in the same location | ||||
| 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 | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891115085 | Alexander H. Arzeno | Orthopaedic Surgery | 510 8th Ave Ne Ste 200, Issaquah, WA 98029-5436 | 2014-04-26 |
| 1922334804 | Alpine Orthopaedic and Spine A Professional Corporation | Orthopaedic Surgery | 212 E Central Ave Ste 365, Spokane, WA 99208-6291 | 2009-10-27 |
| 1912110933 | Virgil V Becker Jr Jd Md Inc Ps | Orthopaedic Surgery | 125 3rd St Ne Ste 401, Auburn, WA 98002-4035 | 2007-05-07 |
| 1003904434 | Farouq A Al-hamdan | Orthopaedic Surgery | 119 S 14th St, Mount Vernon, WA 98274-4114 | 2006-10-11 |
| 1366549040 | Antoine G. Tohmeh | Orthopaedic Surgery | 605 E Holland Ave Ste 200, Spokane, WA 99218-1246 | 2006-09-17 |
| 1447298021 | Paul Edward Schwaegler | Orthopaedic Surgery | 550 16th Ave Ste 404, Seattle, WA 98122-5636 | 2006-06-03 |
| 1588640361 | Michael A Chang | Orthopaedic Surgery | 1211 N 16th Ave, Yakima, WA 98902-1347 | 2005-12-22 |
| 1144228750 | Alan Burchard Brown | Orthopaedic Surgery | 1427 116th Ave Ne, Bellevue, WA 98004-3807 | 2005-07-08 |
| 1699328278 | Bilal Izzat Qutteineh | Orthopaedic Surgery | 550 17th Ave Ste 500, Seattle, WA 98122-5789 | 2019-07-22 |
| 1063924116 | Proliance Surgeons, Inc., P.s | Orthopaedic Surgery | 801 Broadway Ste 617, Seattle, WA 98122-4319 | 2017-10-30 |
| 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.