Providence Physician Group
LBN: Providence Physician Group
Providence Physician Group is an health care organization with primary practice located at 14692 179Th Ave Se Suite 100, Monroe WA 98272-1198. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Technologists, Technicians & Other Technical Service Providers / Bone Densitometry, Suppliers / Durable Medical Equipment & Medical Supplies. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Providence Physician Group can be contacted via phone (360) 794-7994, or through Beegle, Earl D. via phone (425) 316-5470.
Contact Information
Primary practice address
14692 179Th Ave Se Suite 100
Monroe WA 98272-1198
Phone: (360) 794-7994
Fax: (360) 805-4755
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Technologists, Technicians & Other Technical Service Providers / Bone Densitometry | 2471B0102X | ||
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1518040484 |
|---|---|
| LBN Legal business name | Providence Physician Group |
| DBA Doing business as | |
| Authorized official | Beegle, Earl D. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 23rd, 2006 |
| Last updated | Nov 21st, 2007 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518040484 | NPPES |
| Washington | MEDICAID | 7096183 |
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