Providence Physician Group
Pediatrics
Providence Physician Group is a Monroe, Washington based Pediatric center with medical specialization in
General Pediatrics.
It is located at
14692 179th Ave Se, Suite 800, Monroe, Washington - 98272-1198. They can be contacted on phone at
360-794-7994 and fax number 360-805-4757.
NPI number (Unique professional ID) for Providence Physician Group is
1972686848 which was assigned by NPPES on 23 Oct, 2006 and it was last updated on 11 Mar, 2010.
Providence Physician Group is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Providence Physician Group basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Providence Physician Group |
|---|
Business Address:
Providence Physician Group address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 14692 179th Ave Se, Suite 800
Monroe, WA, 98272-1198
United States |
|---|
| Phone Number : | 360-794-7994 |
|---|
| Fax Number : | 360-805-4757 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1972686848 |
|---|
| NPI Entity Type : | Organization |
|---|
| First Enrolment Date : | 23 Oct, 2006 |
|---|
| Last Updated On : | 11 Mar, 2010 |
|---|
Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Barbara Schumacher |
|---|
| Official Title or Position : | PRO FEE CREDENTIALING MANAGER |
|---|
| Phone Number : | 360-794-7994 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Providence Physician Group are as mentioned. Primary taxonomy code for Providence Physician Group is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | No | | |
| 208000000X | Pediatrics | Yes | | |
Legacy Identifiers:
Other legacy medical identifiers of Providence Physician Group such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 7096183 | MEDICAID | WA | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 909 N Broadway, Pbo/credentialing
Everett, WA, 98201-1409
United States |
|---|
| Phone Number : | 425-317-0246 |
|---|
| Fax Number : | 425-317-0291 |
|---|
Business Location:
Patients can refer following map for directions to
Providence Physician Group practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.