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Providence Health & Services - Washington

Organization Active NPI Critical Access Hospital · Colville, WA

NPI 1003067679 · NPPES record last updated May 8, 2025

Key facts

NPI
1003067679
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
Legal business name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Practice address
982 E Columbia Ave
Colville, WA 99114-3316
Phone
(509) 684-2561
Fax
(509) 685-2492
NPI assigned
Oct 1, 2008
Organization subpart
No

Authorized official

Name
Mr. Donald Wayne Anderson Jr.
Title
Assistant Secreatry for Enrollment
Phone
(425) 358-9786

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 45

Affiliated clinicians 303

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 303

Medicare Care Compare: Hospital

Listed as
Providence Mount Carmel Hospital CCN 501326
Overall star rating
★★★☆☆ 3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Hospital certification: CCN 501326

Legal name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Doing business as
PROVIDENCE MOUNT CARMEL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jun 1, 2003
Last certification
Jul 12, 2007
Beds
25
Ownership / control type
Church
Most recent change of ownership
Jan 1, 2009 (2 total)
Organization structure
Corporation · Non-profit
Incorporated
Jan 28, 1859 in WA
Enrollment address
982 E Columbia Ave
Colville, WA 99114-3316
Other Hospital Practice Location

All disclosed owners & managing parties 25

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Diane L Hejna
Individual 		Corporate Director Jul 1, 2016
Richard S Blair
Individual 		Corporate Director Jul 1, 2016
Marvin O'Quinn
Individual 		Corporate Director
Board of Directors		 Jan 1, 2024
Anthony Lawrence
Individual 		W-2 Managing Employee Nov 29, 1993
Linda Buck
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Justin Voelker
Individual 		W-2 Managing Employee
Financial Executive		 Jul 1, 2024
Providence Health & Services - Washington
Organization · Renton, WA
Corporation, Non-profit 		5% Or Greater Direct Ownership Interest Jan 1, 2011 100%
Operational/Managerial Control Jan 1, 2011
Mary E Lyons
Individual 		Corporate Director Jul 1, 2016
Phyllis M Hughes
Individual 		Corporate Director Jan 1, 2014
Rogelio Riojas
Individual 		Corporate Director
Board Member		 Jan 1, 2025
James Martin
Individual 		Corporate Officer
Assistant Treasurer		 Jan 13, 2023
Charles Wallace Sorenson
Individual 		Corporate Director
Board Member		 Jan 1, 2019
Donald Wayne Anderson
Individual 		Corporate Officer
Assistant Secretary of Enrollments		 Jan 1, 2017
Gregory David Hoffman
Individual 		Corporate Officer
Corporate Secretary		 Oct 1, 2020
Isiaah D Crawford
Individual 		Corporate Director
Director		 Feb 1, 2012
Ronald G Rehn
Individual 		W-2 Managing Employee
Chief Executive		 Jan 1, 2013
Donna Markham
Individual 		Corporate Director
Board of Directors		 Jan 1, 2024
Michael W Murphy
Individual 		Corporate Director
Board of Directors		 Jan 1, 2020
Providence Health & Services
Organization · Renton, WA
Corporation, Non-profit 		Operational/Managerial Control Jul 1, 2016 100%
Mary Beth Kingston
Individual 		Corporate Director
Board of Directors		 Sep 1, 2022
Eric D Sprunk
Individual 		Corporate Director Jan 1, 2022
Anna R Newsom
Individual 		Corporate Officer
Corporate Secretary		 May 13, 2022
Darryl Elmouchi
Individual 		Corporate Officer
President & Ceo		 Apr 1, 2025
Karin Dufault
Individual 		Corporate Director
Board Member		 Jan 1, 2025
Providence St. Joseph Health
Organization · Renton, WA
Corporation, Non-profit 		Operational/Managerial Control Jul 1, 2016 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20081126000580 WA Part a Provider - Critical Access Hospital 3577623115 Receives reassigned benefits from 43 practitioners
Practice locations: Colville, WA

National Provider Directory

Tax ID family
Providence Health Ser - Wa (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Yes

Addresses

Primary practice location

982 E Columbia Ave
Colville, WA 99114-3316

Mailing address

PO Box 31001-4110
Pasadena, CA 91110-4110
Phone (509) 684-2561

Other names

  • Providence Mount Carmel Hospital Doing business as

Other providers in Colville, WA

All providers in Colville, WA · Critical Access Hospital in Washington

Sources for this page

Verify at the official NPI Registry.