# PROVIDENCE HEALTH & SERVICES - WA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Physician Group - Claremont
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255582649
- **Authorized official:** MS. BARBARA SCHUMACHER (PRO FEE CREDENTIALING MANAGER)
- **Authorized official phone:** (425) 258-7050

## Contact information

- **Practice address:** 5007 CLAREMONT WAY, EVERETT, WA 98203-3321
- **Practice address phone:** (425) 258-7050
- **Practice address fax:** (425) 258-7055
- **Mailing address:** 909 N BROADWAY, PBO/CREDENTIALING, EVERETT, WA 98201-1409
- **Mailing address phone:** (425) 317-0246
- **Mailing address fax:** (425) 317-0291

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 10/04/2008
- **Last updated:** 03/11/2010