Providence Physician Group
LBN: Providence Physician Group
Providence Physician Group is an health care organization with primary practice located at 11603 State Ave Suite G, Marysville WA 98271-8465. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics, 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) 658-6800, or through Schumacher, Barbara via phone (360) 658-6800.
Contact Information
Primary practice address
11603 State Ave Suite G
Marysville WA 98271-8465
Phone: (360) 658-6800
Fax: (360) 658-6819
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1750311783 |
|---|---|
| LBN Legal business name | Providence Physician Group |
| DBA Doing business as | |
| Authorized official | Schumacher, Barbara |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 4th, 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 | 1750311783 | NPPES |
| Washington | MEDICAID | 7907561 |
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