PROVIDENCE PHSYICIAN SERVICES (NPI# 1952687386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952687386 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE PHSYICIAN SERVICES |
| Other Organization Name | PROVIDENCE FAMILY MEDICINE MANITO CLINIC |
| Practice Address |
1919 S. Grand Blvd. Spokane WA 99203 |
| Mailing Address |
Po Box 34439 Seattle WA 98124 |
| Practice Telephone | 5097899925 |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2011-10-31 |
| Authorized Official Name | MR. MICHAEL MALLORY (CRED. SPECIALIST) |
| Authorized Official Telephone | 4255256798 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE PHSYICIAN SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Family Medicine Manito Clinic | Doing Business As Name - Organization |
| Street Address |
1919 S. GRAND BLVD. |
| City | SPOKANE |
| State | WA |
| Zip Code | 99203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164992541 | Ashley Thunder Hawk | Massage Therapist | 1001 W 25th Ave # 2, Spokane, WA 99203 | 2018-11-28 |
| 1134612500 | Jill Johnston | Nurse Practitioner | 1418 S Tacoma St, Spokane, WA 99203 | 2018-06-11 |
| 1356731988 | Rebekah Elizabeth Alice | Midwife | 417 E 28th Ave, Spokane, WA 99203 | 2015-02-03 |
| 1295155455 | Jordan Diamond | Dentist | 2204 E 29th Ave Ste 104, Spokane, WA 99203 | 2014-04-25 |
| 1033411103 | Patricia Mary Bedalov | Speech-Language Pathologist | 1017 W. 26th Ave., Spokane, WA 99203 | 2010-11-23 |
| 1841591310 | Travis Craig Romney | Chiropractor | 1403 S Grand Blvd., Suite 101s, Spokane, WA 99203 | 2010-11-15 |
| 1942518154 | South Hill Pediatric Dentistry | Dentist | 2020 E 29th Avenue, 130, Spokane, WA 99203 | 2010-09-22 |
| 1942512421 | Judy Lynn Budrow | Massage Therapist | 1805 E. 36th, Spokane, WA 99203 | 2010-07-13 |
| 1871741843 | Elisabeth Carroll Bagby | Massage Therapist | 132 W. 32nd Ave., Spokane, WA 99203 | 2008-09-03 |
| 1982818563 | Sonja Rey | Massage Therapist | 1001 W 25th Ave, Spokane, WA 99203 | 2007-05-10 |
| Find all providers in zip 99203 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750916953 | Bavihealth | Family Medicine | 1314 S. Grand Blvd, Ste 2 #142, Spokane, WA 99202-2131 | 2020-03-08 |
| 1407487648 | Direct Primary Care | Family Medicine | 212 E Central Ave Ste 360, Spokane, WA 99208-4502 | 2020-01-27 |
| 1710234190 | Mayfield Family Medicine Pllc | Family Medicine | 5901 N Lidgerwood St Ste 127, Spokane, WA 99208-1122 | 2012-08-06 |
| 1427329762 | Charles Robert Wolfe | Family Medicine | 16320 E Lincoln Rd, Spokane, WA 99217-9571 | 2012-01-18 |
| 1295016145 | Providence Physician Services Co | Family Medicine | 801 W. 5th Ave, Suite 307, Spokane, WA 99204 | 2011-09-06 |
| 1548552326 | Providence Physician Service Co | Family Medicine | 1919 S Grand Ave, Pmg Providence Family Medicine South Grand, Spokane, WA 99204 | 2011-05-11 |
| 1104125418 | David Raymond O'brien | Family Medicine | 1907 W Summit Pkwy Apt 306, Spokane, WA 99201-3133 | 2011-03-25 |
| 1144540915 | Elizabeth A. Turner, Md | Family Medicine | 316 W. Boone, Suite 669, Spokane, WA 99201-2354 | 2010-06-03 |
| 1083949374 | Opportunity Medical | Family Medicine | 16201 E. Indiana Ave, Ste 2300, Spokane, WA 99216-2839 | 2009-10-05 |
| 1437483856 | Elizabeth A Deniro | Family Medicine | 2828 W Mallon Ave, Spokane, WA 99201-1553 | 2009-10-01 |
| Find all providers in SPOKANE | ||||
Please comment or provide details below to improve the information on PROVIDENCE PHSYICIAN SERVICES.
| 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.