PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI# 1902141500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902141500 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES WASHINGTON |
| Other Organization Name | PROVIDENCE MEDICAL GROUP LAB- PHYSICIANS CLINIC |
| Practice Address |
820 S Mcclellan St Ste Ll10 Spokane WA 99204-2446 |
| Mailing Address |
Po Box 421 Liberty Lake WA 99019-0421 |
| Practice Telephone | 5093534260 |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2018-07-30 |
| Authorized Official Name | SEAN M DOUGLAS (CFO) |
| Authorized Official Telephone | 5094746608 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Providence Medical Group Lab- Physicians Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134656135 | Providence Health & Services Washington | Clinic/Center | 1018 Capitol Way S Ste 300, Olympia, WA 98501-1212 | 2017-05-22 |
| 1023550050 | Providence Health & Services Washington | Psychologist | 225 State Ave Ne, Olympia, WA 98501-6951 | 2016-11-08 |
| 1003367863 | Providence Health & Services Washington | Radiology | 4800 College St Se Ste E, Lacey, WA 98503-4389 | 2016-10-17 |
| 1023563897 | Providence Health & Services Washington | Clinic/Center | 1705 Se Meadowbrook Blvd, Suite 2, College Place, WA 99324-1756 | 2016-08-22 |
| 1457721250 | Providence Health & Services Washington | Clinic/Center | 1200 Basich Blvd, Aberdeen, WA 98520-1035 | 2015-10-06 |
| 1881907715 | Providence Health & Services Washington | Internal Medicine | 62 W 7th Ave, Spokane, WA 99204-2321 | 2010-07-20 |
| 1073744850 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 2505 Olympic Hwy N., Ste 140, Shelton, WA 98584-2978 | 2009-07-28 |
| 1770714693 | Providence Health & Services Washington | Rehabilitation, Substance Use Disorder Unit | 508 1/2 Eighth Street, Hoquiam, WA 98550-3521 | 2009-07-28 |
| 1033309604 | Providence Health & Services Washington | Family Medicine | 1450 Northwest Lane Se, Lacey, WA 98503-6908 | 2007-07-30 |
| 1407055759 | Providence Health & Services Washington | Rehabilitation Unit | 410 Providence Ln., Building 2, Olympia, WA 98506-5101 | 2007-07-17 |
| Street Address |
820 S MCCLELLAN ST STE LL10 |
| City | SPOKANE |
| State | WA |
| Zip Code | 99204-2446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982250957 | Megan Elizabeth Dibenedetto | Pharmacist | 105 West 8th Avenue, 350e, Spokane, WA 99204 | 2019-08-14 |
| 1619521168 | Evelyn R Cabon | Genetic Counselor, MS | 101 W. 8th Avenue Suite 1100, Spokane, WA 99204 | 2019-08-01 |
| 1346700655 | Christina Rose | Student in an Organized Health Care Education/Training Program | 120 W. 8th Avenue, Spokane, WA 99204 | 2019-03-22 |
| 1508339862 | Cody J French | Physical Therapist | Washington Outpatient Rehab, 507 S Washington, Spokane, WA 99204 | 2019-01-09 |
| 1730655598 | Washington Outpatient Rehabilitation, LLC | Physical Therapist | 507 S. Washington St., Suite 10, Spokane, WA 99204 | 2018-10-19 |
| 1013405547 | Joel James Hayden | Student in an Organized Health Care Education/Training Program | Providence Sacred Heart, 101 West 8th Avenue, Spokane, WA 99204 | 2018-04-30 |
| 1144694787 | Brooksjohnsonpllc | Dentist | 1004 S. Monroe Street, Ste 100, Spokane, WA 99204 | 2015-11-19 |
| 1497184196 | Kathalene M Cassels | Physician Assistant | 810 W. 5th Ave. Ste 510, Spokane, WA 99204 | 2013-11-04 |
| 1174880454 | Kelly E Wurzel | Psychiatry & Neurology | 624 E. Front Ave, Spokane, WA 99204 | 2012-04-11 |
| 1003190331 | Katie L Gomez | Nurse Practitioner | 805 W. 5th Ave, Suite 518, Spokane, WA 99204 | 2011-10-05 |
| Find all providers in zip 99204 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053920124 | Aark Laboratory | Clinical Medical Laboratory | 12709 E Mirabeau Pkwy Bldg A Ste 500, Spokane, WA 99216 | 2020-07-24 |
| 1851850218 | Advantage Dx Inc | Clinical Medical Laboratory | 1801 W Broadway Ave, Spokane, WA 99201-1819 | 2019-03-15 |
| 1649767948 | Laboratory Corporation of America | Clinical Medical Laboratory | 110 W Cliff Dr Ste 100-200, Spokane, WA 99204-3614 | 2018-04-23 |
| 1154818565 | Laboratory Corporation of America | Clinical Medical Laboratory | 6120 N Mayfair St Ste 101, Spokane, WA 99208-1033 | 2018-04-20 |
| 1194110734 | Allele Diagnostics Inc. | Clinical Medical Laboratory | 120 N Pine St Ste 152, Suite 202, Spokane, WA 99202-5030 | 2015-03-31 |
| 1902131857 | Pathology Associates Medical Laboratories LLC | Clinical Medical Laboratory | 110 W Cliff Dr Ste 300-400, Spokane, WA 99204-3614 | 2009-10-09 |
| 1407948342 | Mediline Professional Services,inc | Clinical Medical Laboratory | 4407 N Division St Ste 417, Spokane, WA 99207-1613 | 2006-09-28 |
| 1659480291 | Prime Diagnostics Inc | Clinical Medical Laboratory | 7307 N Division St # 204, Spokane, WA 99208-6545 | 2006-08-29 |
| 1003827593 | Physicians Clinic of Spokane | Clinical Medical Laboratory | 820 S. Mcclellan #ll10, Spokane, WA 99204 | 2006-08-10 |
| 1740248848 | Signature Genomic Laboratories, LLC | Clinical Medical Laboratory | 2820 N Astor St, Spokane, WA 99207-2112 | 2006-05-01 |
| 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.