PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI# 1982848057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982848057 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| Other Organization Name | PROVIDENCE CHASE MEDICAL COMPLEX DME |
| Practice Address |
380 Chase Ave Walla Walla WA 99362-2924 |
| Mailing Address |
209 W Poplar St Po Box 1477 Walla Walla WA 99362-2828 |
| Practice Telephone | 5095263333 |
| Practice Fax Number | 5095225789 |
| Mailing Telephone | 5095225906 |
| Mailing Fax Number | 5095225789 |
| Enumeration Date | 2009-04-21 |
| Last Update Date | 2009-04-21 |
| Authorized Official Name | SUSAN A COLUMBER (RCM DIRECTOR) |
| Authorized Official Telephone | 5095225906 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | HAC.FS.00000050 | WA | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| Providence Chase Medical Complex DME | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407162571 | Providence Health & Services - Washington | Internal Medicine | 510 E Amende Drive, Odessa, WA 99159-0000 | 2010-08-26 |
| 1841503034 | Providence Health & Services - Washington | Family Medicine | 18313 Paulsonst Sw, Suite A, Rochester, WA 98579-9262 | 2010-07-16 |
| 1083947709 | Providence Health & Services - Washington | Hospice Care, Community Based | 2731 Wetmore Ave Ste 500, Everett, WA 98201-3585 | 2009-09-14 |
| 1760636690 | Providence Health & Services - Washington | Neurological Surgery | 301 W Poplar Street, Ste 220, Walla Walla, WA 99362-2800 | 2008-11-05 |
| 1558512368 | Providence Health & Services - Washington | Home Health | 209 W Poplar St, Walla Walla, WA 99362 | 2008-10-10 |
| 1922259738 | Providence Health & Services - Washington | Internal Medicine | 380 Chase Avenue, Pmg Se Wa, Walla Walla, WA 99362-2924 | 2008-10-10 |
| 1306097126 | Providence Health & Services - Washington | Radiology | 401 W Poplar Street, Pmg Se Wa Imaging, Walla Walla, WA 99362-2846 | 2008-10-10 |
| 1043374119 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 508 Quarter Eighth Street, Hoquiam, WA 98550 | 2006-12-21 |
| 1073677605 | Providence Health & Services - Washington | Rehabilitation, Substance Use Disorder Unit | 506 W Franklin St, Shelton, WA 98584-3517 | 2006-12-20 |
| 1003906918 | Providence Health & Services - Washington | Home Health | 3432 Bay Rd Ne, Olympia, WA 98506-2958 | 2006-10-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Washington | 1801 Lind Ave. Sw, #9016, Renton, WA 98057 |
| Street Address |
380 CHASE AVE |
| City | WALLA WALLA |
| State | WA |
| Zip Code | 99362-2924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235113606 | Jean L Sherman | Registered Nurse | 380 Chase Ave, Coumadin/wound Clinic, Walla Walla, WA 99362-2924 | 2005-11-30 |
| 1619459815 | Briana Maynor | Nurse Practitioner | 380 Chase Ave, Walla Walla, WA 99362-2924 | 2018-09-04 |
| 1407340730 | Michael James Henderson | Nurse Practitioner | 380 Chase Ave, Walla Walla, WA 99362-2924 | 2018-06-20 |
| 1326569682 | Providence Health & Services - Washington | Internal Medicine | 380 Chase Ave, Walla Walla, WA 99362-2924 | 2017-06-27 |
| 1699205765 | Kenna E Marx | Pharmacist | 380 Chase Ave, Walla Walla, WA 99362-2924 | 2017-06-12 |
| 1851839682 | Graycen Duffy | Nurse Practitioner | 380 Chase Ave, Walla Walla, WA 99362-2924 | 2017-01-31 |
| 1184003295 | Joshua Wicks | Physician Assistant | 380 Chase Ave, Walla Walla, WA 99362-2924 | 2015-05-21 |
| 1134467582 | Dalari Allington | Pharmacist | 380 Chase Ave, Walla Walla, WA 99362-2924 | 2013-01-18 |
| 1578867842 | Lisa Maurer Must | Physician Assistant | 380 Chase Ave, Walla Walla, WA 99362-2924 | 2010-12-30 |
| 1558599654 | John R. Stoddard | Family Medicine | 380 Chase Ave, Providence Medical Group, Walla Walla, WA 99362 | 2009-06-26 |
| 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 | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932565785 | Cherie Lea Gardner Dba Zounds Hearing | Preferred Provider Organization | 401 W Main St, Suite 105, Walla Walla, WA 99362-2837 | 2016-01-10 |
| 1548533490 | Johnston Chiropractic LLC | Preferred Provider Organization | 216 N Roosevelt St, Walla Walla, WA 99362-2537 | 2012-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225529407 | Mitchell International, Inc. | Preferred Provider Organization | 1301 5th Ave Ste 2900, Seattle, WA 98101-2644 | 2018-05-23 |
| 1629517388 | Shera Looney | Preferred Provider Organization | 500 5th Ave W, 502, Seattle, WA 98119-3957 | 2017-02-14 |
| 1538615158 | J.r. Craig Webster D.d.s. | Preferred Provider Organization | 204 West 1st. Street, Omak, WA 98841 | 2016-09-01 |
| 1306390109 | Sabrina Mandich, Dds, LLC | Preferred Provider Organization | 207 Sw 156th St Ste 1, Burien, WA 98166-2561 | 2016-08-09 |
| 1083168272 | Marnie L. Collins Dds | Preferred Provider Organization | 507 N Sullivan Rd Ste 2, Spokane Valley, WA 99037-8576 | 2016-08-05 |
| 1720431414 | David J Olson Dds Pllc | Preferred Provider Organization | 509 Olive Way Ste 1238, Seattle, WA 98101-1745 | 2016-07-18 |
| 1932558780 | Cheng Im Shao Chue Gomez Pllc | Preferred Provider Organization | 22035 Se Wax Rd, Ste 5, Maple Valley, WA 98038-8543 | 2016-06-11 |
| 1659741858 | Canyon Crossing Chiropractic Ps | Preferred Provider Organization | 5610 176th St E, D105, Puyallup, WA 98375-9305 | 2015-09-30 |
| 1336519982 | Dr. James Hood | Preferred Provider Organization | 2510 N Pines Rd Ste 206, Spokane Valley, WA 99206-7636 | 2015-09-25 |
| 1134504145 | Body Kneads Massage Therapy | Preferred Provider Organization | 445 Cedar Blvd., Suite C, Othello, WA 99344 | 2015-07-21 |
| 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.