Providence Physician Group
LBN: Providence Physician Group
Providence Physician Group is an health care organization with primary practice located at 1330 Rockefeller Ave Suite 210, Everett WA 98201-1684. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease, Suppliers / Durable Medical Equipment & Medical Supplies. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty.
Providence Physician Group can be contacted via phone (425) 261-4940, or through Schumacher, Barbara via phone (425) 261-4940.
Contact Information
Primary practice address
1330 Rockefeller Ave Suite 210
Everett WA 98201-1684
Phone: (425) 261-4940
Fax: (425) 261-4945
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | ||
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1609800861 |
|---|---|
| LBN Legal business name | Providence Physician Group |
| DBA Doing business as | |
| Authorized official | Schumacher, Barbara |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Mar 11th, 2010 - about 14 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 | 1609800861 | NPPES |
| Washington | MEDICAID | 7095417 |
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