Provider Demographics
NPI:1457665945
Name:PROVIDENCE HEALTH & SERVICES
Entity Type:Organization
Organization Name:PROVIDENCE HEALTH & SERVICES
Other - Org Name:PROVIDENCE SPOKANE HEART INSTITUTE-ST. MARYS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIRECTOR OF REVENUE CYCLE MGT.
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-254-5362
Mailing Address - Street 1:PO BOX 3776
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-3776
Mailing Address - Country:US
Mailing Address - Phone:425-525-6798
Mailing Address - Fax:425-525-6700
Practice Address - Street 1:701 LEWISTON STREET
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:ID
Practice Address - Zip Code:83522-0000
Practice Address - Country:US
Practice Address - Phone:208-962-3267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-27
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty