Provider Type Icon

PROVIDENCE EVERETT MEDICAL CENTER NPI 1972610418


NPI Information

NPI: 1972610418
Provider Name: PROVIDENCE EVERETT MEDICAL CENTER

Doing Business As: PEMC MENTAL HEALTH CONSULTATION SERVICES

Classification: Psychiatry & Neurology - 2084A0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
1321 COLBY AVE
EVERETT, WA
ZIP 98201
Phone: (425) 261-3968
Get Directions

PROVIDENCE EVERETT MEDICAL CENTER is an addiction medicine psychiatry neurology in Everett, WA. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine PROVIDENCE EVERETT MEDICAL CENTER NPI is 1972610418. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pemc Mental Health Consultation Services.

The provider's business location address is:

1321 COLBY AVE
EVERETT, WA
ZIP 98201-665
Phone: (425) 261-3968
Fax: (425) 261-3967

The provider's authorized official is Joyce Kobayashi .
The authorized official title is Dir Revenue Cycle Mgmt Nwsa and has the following contact phone number (425) 317-0186.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 9/23/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthWASHINGTONNo
22084A0401XPsychiatry & NeurologyAddiction MedicineWASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17075161MEDICAIDWASHINGTON
2G115139200MEDICARE PINWASHINGTON
37128150MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.