PROVIDENCE PHYSICIAN SERVICES CO (NPI# 1891001277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891001277 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Other Organization Name | PROVIDENCE PEDIATRIC NORTH |
| Practice Address |
5901 N Linderwood Suite 126 Spokane WA 99207 |
| Mailing Address |
Po Box 34439 Seattle WA 98124-1439 |
| Practice Telephone | 5094895110 |
| Mailing Telephone | 4255256798 |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-08-24 |
| Authorized Official Name | KEVIN WALSTROM (CFO) |
| Authorized Official Telephone | 5094822367 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE PHYSICIAN SERVICES CO |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PROVIDENCE PEDIATRIC NORTH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740566173 | Providence Physician Services Co | Internal Medicine | 212 Central Ave Suite 440, Spokane, WA 99208 | 2011-10-31 |
| 1295016145 | Providence Physician Services Co | Family Medicine | 801 W. 5th Ave, Suite 307, Spokane, WA 99204 | 2011-09-06 |
| 1619268281 | Providence Physician Services Co | Family Medicine | 100 W. South Ave Chewelah, Chewelah, WA 99109 | 2011-04-29 |
| 1184915829 | Providence Physician Services Co | Family Medicine | 5011 W. Lowell Ave, Seattle, WA 99208-8587 | 2011-04-28 |
| 1578869913 | Providence Physician Services Co | Family Medicine | 12704 E Nora Ave, Ste B, Spokane Valley, WA 99216-1140 | 2011-02-02 |
| 1245557917 | Providence Physician Services Co | Obstetrics & Gynecology | 518 Clay Street, Chewelah, WA 99109 | 2010-04-21 |
| 1215223953 | Providence Physician Services Co | Prosthetic/Orthotic Supplier | 101 W 8th Ave, Mother Gamelin Center, 3rd Floor, Spokane, WA 99204-2307 | 2011-06-21 |
| 1336433812 | Providence Physician Services Co | Family Medicine | 104 W 5th Ave, Suite 390e, Spokane, WA 99204 | 2011-06-02 |
| 1053618892 | Providence Physician Services Co | Internal Medicine | 105 W 8th Ave, Ste 550e, Spokane, WA 99204-2302 | 2011-02-14 |
| 1356646202 | Providence Physician Services Co | Surgery | 122 W 7th Ave, Ste 420, Spokane, WA 99204-2349 | 2011-01-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE PHYSICIAN SERVICES CO. | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Street Address |
5901 N LINDERWOOD SUITE 126 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437669231 | Rebecca Althouse | Massage Therapist | 59 E. Queen Ave. Suite 104, Spokane, WA 99207 | 2017-10-05 |
| 1891142105 | Kathleen Annette Love | Counselor | 2702 N. Perry, Spokane, WA 99207 | 2016-05-17 |
| 1184094831 | Rachel Robles | Massage Therapist | 514 E. Providence Ave, Spokane, WA 99207 | 2015-10-06 |
| 1114345022 | Lindsay Urso | Physician Assistant | 4001 N. Cook St, Riverstone Family Health, Spokane, WA 99207 | 2014-03-29 |
| 1780936930 | Amber Elizabeth Riemersma | Midwife | 127 E Eculid, Spokane, WA 99207 | 2012-10-12 |
| 1376816108 | Michelle Christine Rees | Massage Therapist | 1504 E. Everett, Spokane, WA 99207 | 2012-02-09 |
| 1750658241 | Zita Lindell Nickeson | Counselor | 4407 N. Division Suite 304, Spokane, WA 99207 | 2011-11-28 |
| 1912282989 | Carolyn C Millen | Pharmacist | 12 E. Empire Ave, Spokane, WA 99207 | 2011-10-20 |
| 1316222730 | Brooke Pickering | Pharmacist | 12 E Empire, Spokane, WA 99207 | 2011-10-17 |
| 1346484276 | Sara M Clark | Psychiatry & Neurology | 235 E Rowan Ave Ste 107, Spokane, WA 99207 | 2009-04-22 |
| Find all providers in zip 99207 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043706583 | Healthy Schools Washington, Pllc | Pediatrics | 1028 West Rosewood Ave, Spokane, WA 99208 | 2018-07-09 |
| 1740690049 | Ashley Claire Mccorkhill | Pediatrics | 1514 S Tacoma St, Spokane, WA 99203-2260 | 2014-05-07 |
| 1568591923 | Bridget Z Duffy | Pediatrics | 1111 E Westview Ct Ste B, Spokane, WA 99218-1376 | 2007-03-03 |
| 1831296177 | Deborah Ann Icenogle | Pediatrics | 5011 W Lowell Ave Ste 100, Spokane, WA 99208-8587 | 2006-09-20 |
| 1417061169 | Joseph B Mcmanus | Pediatrics | 5901 N Lidgerwood, Suite 220, Spokane, WA 99208 | 2006-08-19 |
| 1962494393 | David R Fregeau | Pediatrics | 101 W Eighth, Spokane, WA 99220-2555 | 2005-08-22 |
| 1932680949 | Spokane Pediatrics Pllc | Pediatrics | 315 W 9th Ave Ste 200, Spokane, WA 99204 | 2018-08-27 |
| 1396253910 | Grand Pediatrics, P.s. | Pediatrics | 1402 S Grand Blvd, Spokane, WA 99203-5001 | 2018-01-17 |
| 1275053514 | Angela Denise Beauchamp | Pediatrics | 1402 S Grand Blvd, Spokane, WA 99203-5001 | 2017-06-27 |
| 1992182885 | Joshua Geeming Lee | Pediatrics | 101 W 8th Ave, Spokane, WA 99204-2307 | 2015-04-30 |
| Find all providers in SPOKANE | ||||
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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.