Provider Demographics
NPI:1689977159
Name:PROVIDENCE HEALTH & SERVICES
Entity Type:Organization
Organization Name:PROVIDENCE HEALTH & SERVICES
Other - Org Name:PROVIDENCE SPOKANE HEART INSTITUTE-COEUR D'ALENE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR DIRECTORY OF REVENUE CYCLE MNGMT
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:425-525-6715
Mailing Address - Fax:425-525-6700
Practice Address - Street 1:700 W IRONWOOD DR
Practice Address - Street 2:SUITE 350
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2656
Practice Address - Country:US
Practice Address - Phone:208-676-9913
Practice Address - Fax:208-666-0885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty