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PROVIDENCE PHYSICIAN GROUP NPI 1073699922


NPI Information

NPI: 1073699922
Provider Name: PROVIDENCE PHYSICIAN GROUP
Classification: Neurological Surgery - 207T00000X
Entity Type: Organization
Address:
2320 RUCKER AVE
SUITE A
EVERETT, WA
ZIP 98201
Phone: (425) 259-5121
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PROVIDENCE PHYSICIAN GROUP is a neurological surgery in Everett, WA. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. PROVIDENCE PHYSICIAN GROUP NPI is 1073699922. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2320 RUCKER AVE
SUITE A
EVERETT, WA
ZIP 98201-723
Phone: (425) 259-5121
Fax: (425) 252-1322

The provider's authorized official is Barbara Schumacher .
The authorized official title is Pro Fee Credentialing Manager and has the following contact phone number (425) 259-5121.

The enumeration date for this NPI number is 10/31/2006 and was last updated on 3/11/2010.


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
1207T00000XNeurological SurgeryYes

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
1GAB 08328MEDICARE PINWASHINGTON

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: 4/28/2024

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