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Organization

PROVIDENCE HEALTH & SERVICES - WA

Active
Other names
Providence Physician Group - Claremont
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BARBARA SCHUMACHER (PRO FEE CREDENTIALING MANAGER)
(425) 258-7050
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
10/04/2008
Last updated
03/11/2010
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