PROVIDENCE HEALTH & SERVICES (NPI# 1912210709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912210709 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES |
| Other Organization Name | PROVIDENCE SPOKANE HEART INSTITUTE-WALLA WALLA CLINIC |
| Practice Address |
55 W Tietan St Walla Walla WA 99362-4445 |
| Mailing Address |
Po Box 3776 Seattle WA 98124-3776 |
| Practice Telephone | 5098387711 |
| Mailing Telephone | 4255256798 |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2010-11-05 |
| Authorized Official Name | KAREN DUNCAN (SR. DIRECTOR OF REVENUE CYCLE MGT.) |
| Authorized Official Telephone | 4252545362 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Spokane Heart Institute-Walla Walla Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609322528 | Providence Health & Services | In Home Supportive Care | 110 S. Third Street E., Chewelah, WA 99109 | 2016-08-31 |
| 1811201312 | Providence Health & Services | Internal Medicine | 715 S Washington, Suite A, Moscow, ID 83843-0000 | 2010-07-27 |
| 1720391659 | Providence Health & Services | Internal Medicine | 629 Jasmine St, Omak, WA 98841 | 2010-07-20 |
| 1114230042 | Providence Health & Services | Internal Medicine | 318 E Rowan Ave, 240, Spokane, WA 99207-1200 | 2010-07-20 |
| 1154539203 | Providence Health & Services | Internal Medicine | 1510 Division St Ste 200, Oregon City, OR 97045-1599 | 2007-05-21 |
| 1780742114 | Providence Health & Services | Internal Medicine | 1515 Portland Rd, Newberg, OR 97132-1844 | 2006-12-05 |
| 1831639731 | Providence Health & Services | Home Health Aide | 12800 Bothell Everett Hwy, Suite 290, Everett, WA 98208-6642 | 2017-02-27 |
| 1093056632 | Providence Health & Services | General Acute Care Hospital | 6801 Coldwater Canyon Ave, Suite 1a, North Hollywood, CA 91605-5162 | 2013-03-06 |
| 1689977159 | Providence Health & Services | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 700 W Ironwood Dr, Suite 350, Coeur D Alene, ID 83814-2656 | 2010-12-06 |
| 1245544584 | Providence Health & Services | Internal Medicine | 1550 S Pioneer Way, Pioneer Medical Center #250, Moses Lake, WA 98837-4613 | 2010-07-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - MONTANA | 1801 Lind Ave Sw, Renton, WA 98057 |
| Colorado Business Entities | Providence Health & Services - Montana | Dept of Legal Affairs, 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - MONTANA | 1801 Lind Ave Sw, Renton, WA 98057-3368 |
| Colorado Business Entities | Providence Health & Services - Oregon | 1801 Lind Avenue, Sw, Renton, WA 98057-9016 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 4400 Ne Halsey St Bldg 2 Ste 690, Portland, OR 97213-1545 |
| Iowa Business Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
| Street Address |
55 W TIETAN ST |
| City | WALLA WALLA |
| State | WA |
| Zip Code | 99362-4445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831193747 | Karen Henderson | Pediatrics | 55 W Tietan St, Walla Walla, WA 99362-4445 | 2005-06-08 |
| 1639776370 | Amanda Jo Stepper | Advanced Practice Midwife | 55 W Tietan St, Walla Walla, WA 99362-4445 | 2020-10-06 |
| 1891346649 | David Andrew Forsyth | Registered Nurse | 55 W Tietan St, Walla Walla, WA 99362-4445 | 2019-09-24 |
| 1104306695 | Gunnar Leighton James Sjoren | Physical Therapist | 55 W Tietan St, Walla Walla, WA 99362-4498 | 2018-08-15 |
| 1295235281 | Megan Renee Freismidl | Physician Assistant | 55 W Tietan St, Walla Walla, WA 99362-4445 | 2018-02-15 |
| 1508388992 | Rosemary Welser | Social Worker | 55 W Tietan St, Walla Walla, WA 99362-4445 | 2017-07-07 |
| 1093190886 | Diana Fitzgerald | Audiologist | 55 W Tietan St, Walla Walla, WA 99362-4445 | 2015-07-22 |
| 1962885210 | Ronald Q. Ferranco | Nurse Practitioner | 55 W Tietan St, Walla Walla, WA 99362-4445 | 2015-07-06 |
| 1083096440 | Rebekah Dickman | Pediatrics | 55 W Tietan St, Walla Walla, WA 99362 | 2015-06-22 |
| 1851787709 | Brent E Winterbottom | Physical Therapist | 55 W Tietan St, Walla Walla, WA 99362-4445 | 2015-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164065959 | Kevin Gia-minh Phan | Optometrist | Walla Walla Vamc Bldg 86, Walla Walla, WA 99362 | 2019-10-24 |
| 1659836401 | Arlene Lavonne Whitney | Social Worker | 1361 Dalles Military Road, Walla Walla, WA 99362 | 2019-02-06 |
| 1053880674 | Julie Ann Cooke | Speech-Language Pathologist | Providence St. Mary Medical Center, 401 W. Poplar St., Walla Walla, WA 99362 | 2018-11-14 |
| 1558887133 | Chantey Walker | Massage Therapist | 1840 Pleasant St, Walla Walla, WA 99362 | 2017-08-16 |
| 1447798723 | Carrie S Diede | Speech-Language Pathologist | 410 West Poplar Street, Rehabilitation Services, Walla Walla, WA 99362 | 2017-02-07 |
| 1235584103 | Anchor Point Counseling Pllc | Clinic/Center | 2330 Eastgate St. Ste. 140, Walla Walla, WA 99362 | 2016-04-28 |
| 1548627011 | Washington State Walla Walla Veterans Home | Skilled Nursing Facility | 92 Wainwright Drive, Walla Walla, WA 99362 | 2016-01-28 |
| 1073926200 | Sherry Goff | Registered Nurse | 11120 W Rose St, Family Medical Center, Walla Walla, WA 99362 | 2014-06-05 |
| 1538597935 | Michael Wade Gillespie | Orthopaedic Surgery | 101 Brookside Drive, Walla Walla, WA 99362 | 2013-10-22 |
| 1023357985 | Sandra Kay Bushnell | Speech-Language Pathologist | 1105 Isaacs Ave, Walla Walla, WA 99362 | 2013-02-12 |
| Find all providers in zip 99362 | ||||
| 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 |
|---|---|---|---|---|
| 1255452058 | Walla Walla Cardiology Specialist Clinic,p.s. | Internal Medicine | 1103 S 2nd Ave, Suite A, Walla Walla, WA 99362-4118 | 2007-04-02 |
| 1295792281 | Ronny Y Yu | Internal Medicine | 1103a S 2nd Ave, Walla Walla, WA 99362-4118 | 2006-04-26 |
| 1629382122 | Providence Health & Services - Washington | Internal Medicine | 401 W Poplar St, Cardiology Suite, Walla Walla, WA 99362-2846 | 2010-07-27 |
| 1770539991 | S Steven Maxood | Internal Medicine | 401 W Poplar St, Walla Walla, WA 99362-2846 | 2006-05-26 |
| 1497700975 | Suwong Wongsuwan | Internal Medicine | 401 W Poplar St, St Mary Medical Center, Cardiology Suite, Walla Walla, WA 99362-2846 | 2006-05-23 |
| 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 | ||||
| City | WALLA WALLA |
| Zip Code | 99362 |
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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.