PROVIDENCE EVERETT MEDICAL CENTER (NPI# 1992871735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992871735 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE EVERETT MEDICAL CENTER |
| Other Organization Name | PROVIDENCE EVERETT HEALTHCARE CLINIC |
| Practice Address |
1001 N Broadway Suite A-3 Everett WA 98201-1586 |
| Mailing Address |
909 N Broadway Pbo Credentialing Everett WA 98201-1409 |
| Practice Telephone | 4253170300 |
| Practice Fax Number | 4253170303 |
| Mailing Telephone | 4253170699 |
| Mailing Fax Number | 4253170291 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2008-09-23 |
| Authorized Official Name | MRS. JOYCE KOBAYASHI (DIR REVENUE CYCLE MGMT NWSA) |
| Authorized Official Telephone | 4253170186 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
WA | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 207X00000X | Orthopaedic Surgery | WA | Allopathic & Osteopathic Physicians | |
| N | 207Q00000X | Family Medicine | WA | Allopathic & Osteopathic Physicians | |
| N | 207R00000X | Internal Medicine | WA | Allopathic & Osteopathic Physicians | |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
WA | Behavioral Health & Social Service Providers | |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
WA | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 363A00000X | Physician Assistant | WA | Physician Assistants & Advanced Practice Nursing Providers | |
| N | 261QF0050X |
Clinic/Center Specialization: Family Planning, Non-Surgical |
WA | Ambulatory Health Care Facilities | |
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | MEDICAID CLINICAL PSYCHOL | 7136880 | 01 |
| WA | FAMILY PLANNING | 7901341 | 01 |
| WA | MEDICAID MENTAL HEALTH | 9650268 | 01 |
| WA | MEDICARE GROUP NUMBER | GAB39976 | 01 |
| WA | MEDICAID FAMILY PRACTICE | 7119365 | 01 |
| Other Name | Type Code |
|---|---|
| Providence Everett Healthcare Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073773198 | Providence Everett Medical Center | Clinic/Center | 4112 Harbour Pointe Blvd, Suite 100, Mukilteo, WA 98275-4700 | 2008-06-12 |
| 1982805784 | Providence Everett Medical Center | Social Worker | 900 Pacific Ave, First Floor, Everett, WA 98201-4168 | 2007-05-30 |
| 1538377957 | Providence Everett Medical Center | Clinical Medical Laboratory | 1321 Colby Ave, Everett, WA 98201-1665 | 2007-05-18 |
| 1063551596 | Providence Everett Medical Center | Clinic/Center | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2007-02-05 |
| 1740344100 | Providence Everett Medical Center | Nutritionist | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2006-12-20 |
| 1255495024 | Providence Everett Medical Center | Nutritionist | 900 Pacific Ave, First Floor, Everett, WA 98201-4168 | 2006-12-19 |
| 1770643629 | Providence Everett Medical Center | Nurse Practitioner | 916 Pacific Ave, 1 South, Everett, WA 98201-4147 | 2006-12-11 |
| 1104993716 | Providence Everett Medical Center | Nurse Practitioner | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2006-11-29 |
| 1447326574 | Providence Everett Medical Center | Clinic/Center | 900 Pacific Ave, Suite 200, Everett, WA 98201-4168 | 2006-11-28 |
| 1740365766 | Providence Everett Medical Center | Dietitian, Registered | 916 Pacific Ave, 7th Floor, Everett, WA 98201-4147 | 2006-10-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PROVIDENCE EVERETT MEDICAL CENTER | 1321 Colby Ave, Everett, WA 98206 |
| Street Address |
1001 N BROADWAY SUITE A-3 |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-1586 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003870023 | Timothy Edward Mcnamara | Internal Medicine | 1001 N Broadway, Suite A3, Everett, WA 98201-1586 | 2006-04-14 |
| 1396182200 | Seattle Pain Center Medical Corporation | Pain Medicine | 1001 N Broadway, Ste A3, Everett, WA 98201-1586 | 2013-05-31 |
| 1588966725 | Heather L Morris | Registered Nurse | 1001 N Broadway, Everett, WA 98201-1586 | 2010-11-19 |
| 1811223894 | Heike Ingrid Nuhsbaum | Registered Nurse | 1001 N Broadway, Suite A-3, Everett, WA 98201-1585 | 2009-10-26 |
| 1871744268 | Providence Health & Services-wa | Counselor | 1001 N Broadway, Suite A-3, Everett, WA 98201-1586 | 2008-10-04 |
| 1265604169 | Cheryl Crance | Dietary Manager | 1001 N Broadway, Suite A-3, Everett, WA 98201-1586 | 2008-03-31 |
| 1487825782 | Matthew J Beecroft | Emergency Medicine | 1001 N Broadway, Ste A11, Everett, WA 98201-1586 | 2008-03-14 |
| 1548457039 | Susan J Jones | Nurse Practitioner | 1001 N Broadway, Suite A3, Everett, WA 98201-1586 | 2007-09-27 |
| 1528269495 | Pablo Mejia | Psychologist | 1001 N Broadway, Suite A3, Everett, WA 98201-1586 | 2007-05-30 |
| 1922136308 | Patricia A Brandt | Counselor | 1001 N Broadway, 3, Everett, WA 98201-1586 | 2007-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306471867 | Shannon Michelle Dewald | Registered Nurse | D8s 1700 13th St, Everett, WA 98201 | 2020-03-05 |
| 1578123113 | Precious Medicial Spa, LLC | Registered Nurse | 1728 W. Marine View Dr Suite 212, Everett, WA 98201 | 2019-06-17 |
| 1508429796 | Alix Deschain | Counselor | 2801 Broadway, Everett, WA 98201 | 2019-04-15 |
| 1811457534 | Khushboo Patel | Pharmacist | 1330 Rockefeller Ave Ste 150, Everett, WA 98201 | 2019-03-20 |
| 1164991188 | Grace Talbot Davis | Registered Nurse | 2601 Summit Avenue, Bldg. C, Everett, WA 98201 | 2018-11-20 |
| 1063924603 | Tracy Sisk | Counselor | 3120 Colby Ave, 502, Everett, WA 98201 | 2017-11-03 |
| 1710403126 | Michelle Durham | Counselor | 3322 Boadway Fl 2, Everett, WA 98201 | 2017-08-17 |
| 1861927949 | Melanie Schmidt | Counselor | 2610 Westmore Ave, Everett, WA 98201 | 2017-04-26 |
| 1518413327 | Joseph Madson Dmd Pllc | Clinic/Center | 3802 Colby Ave, 4th Floor, Everett, WA 98201 | 2016-08-31 |
| 1043683162 | Jennifer Adams | Counselor | 1511 26th St, Everett, WA 98201 | 2015-11-11 |
| Find all providers in zip 98201 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982212510 | Saint Joseph Clinic | Clinic/Center | 41 W 1st St, Everett, PA 15537-1103 | 2020-07-20 |
| 1437675188 | Community Health Center of Snohomish County | Clinic/Center | 930 N Broadway, Everett, WA 98201-1409 | 2017-08-15 |
| 1548786296 | Community Health Center of Snohomish County | Clinic/Center | 4201 Rucker Ave, Everett, WA 98203-2237 | 2017-08-15 |
| 1699102129 | Community Health Center of Snohomish County | Clinic/Center | 1424 Broadway, Everett, WA 98201-1720 | 2013-09-30 |
| 1255645701 | Emerisse Camille Shen | Clinic/Center | 1410 Broadway, Everett, WA 98201-1720 | 2010-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699375345 | Community Health Care | Clinic/Center | 15610 89th St. Ct. Kpn, Lakebay, WA 98349-9840 | 2020-10-30 |
| 1063026391 | Community Health Care | Clinic/Center | 3811 E Arlington Dr Rm 117, Tacoma, WA 98404-4613 | 2020-09-03 |
| 1093351850 | Stork Midwifery | Clinic/Center | 1523 10th St, Marysville, WA 98270-4663 | 2019-11-26 |
| 1891343075 | Country Doctor Community Clinic | Clinic/Center | 1621 S Jackson St Ste 201, Seattle, WA 98144-2277 | 2019-08-30 |
| 1497314819 | Community Health Care | Clinic/Center | 22001 38th Ave E Rm 111, Spanaway, WA 98387-6875 | 2019-06-10 |
| 1104204957 | Optimal Health and Wellness | Clinic/Center | 1267 Belmont Way, Clarkston, WA 99403 | 2015-05-13 |
| 1891030300 | Fred Meyer Pharmacy | Clinic/Center | 4505 South 19th, Tacoma, WA 98405 | 2012-12-10 |
| 1407076110 | Community Health Care | Clinic/Center | 1202 Martin Luther King Jr. Way, Tacoma, WA 98405 | 2007-04-26 |
| 1831317098 | Community Health Care | Clinic/Center | 3611 S D St, Suite 7, Tacoma, WA 98418-6813 | 2007-04-23 |
| 1194943308 | Community Health Care | Clinic/Center | 1708 East 44th St, Tacoma, WA 98404-4611 | 2007-04-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PROVIDENCE EVERETT MEDICAL CENTER.
| 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.