Providence Health & Services Washington

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

PROVIDENCE HEALTH & SERVICES WASHINGTON

Doing business as

Providence Medical Group

Practice address

101 W 8TH Ave
Mother Gamelin Center 3Rd Floor
Spokane, WA 99204-2307

Phone

(509) 474-2072

NPI assigned

Mar 6, 2012

Last updated

May 11, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donald Wayne Anderson Jr.

Title

Assistant Secretary of Enrollments

Phone

(425) 358-9786

Specialties & licenses 10

Addresses

Other names 1

• PROVIDENCE MEDICAL GROUP Doing business as

Medicare fee-for-service enrollment

Enrolled in WA, ID, MT, CO, AK, CA, OR, MI, MO, FL, DC, NY, NV, HI, TX, MN, AZ, IL, WI, NE, UT, NC, TN, NJ24 enrollments

Enrollment records 24

Other NPIs with the same Medicare PAC ID 7

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

• Providence Health & Services Washington

  dba Providence NEWMG Colville

  • Rural Health Clinic/Center
  • Colville, WA
  • NPI 1255685822

  0345139929

  Same PAC ID
• Providence Health & Services Washington

  dba Providence Medical Group - Orthopedics South

  • Orthopaedic Surgery Physician
  • Spokane, WA
  • NPI 1376117325

  0345139929

  Same PAC ID
• Providence Health & Services Washington

  dba Providence Northeast Washington Medical Group - Kettle Falls

  • Rural Health Clinic/Center
  • Kettle Falls, WA
  • NPI 1538413109

  0345139929

  Same PAC ID
• Providence Health & Services Washington

  dba Providence Family Medicine Chewelah

  • Rural Health Clinic/Center
  • Chewelah, WA
  • NPI 1639892672

  0345139929

  Same PAC ID
• Providence Health & Services Washington

  dba PMG E Wa PMP Orthopedics DME

  • Orthopaedic Surgery Physician
  • Spokane Valley, WA
  • NPI 1710386818

  0345139929

  Same PAC ID
• Providence Health & Services Washington

  • Orthopaedic Surgery Physician
  • Spokane, WA
  • NPI 1881059954

  0345139929

  Same PAC ID
• Providence Health & Services Washington

  dba Providence Medical Group Lab- Physicians Clinic

  • Clinical Medical Laboratory
  • Spokane, WA
  • NPI 1902141500

  0345139929

  Same PAC ID

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Providence Health & Services - Washington

  dba Providence St. Peter Chemical Dependency Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
  • NPI 1043374119

  O20040311001453

  Same enrollment
• Providence Health & Services - Washington

  dba Providence St. Peter Chemical Dependency Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Shelton, WA
  • NPI 1073677605

  O20040311001453

  Same enrollment
• Providence Health & Services - Washington

  dba Providence St Peter Chemical Dependency Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Lacey, WA
  • NPI 1467462952

  O20040311001453, O20151222000687

  Same enrollment
• Providence Health & Services Washington

  dba Providence North East Washington Medical Group

  • Family Medicine Physician
  • Colville, WA
  • NPI 1083968879

  O20040311001453, O20151222000687

  Same enrollment
• Providence Health & Services Washington

  dba PMG E Wa Newmg Orthopedics DME

  • Orthopaedic Surgery Physician
  • Colville, WA
  • NPI 1245651363

  O20151222000687

  Same enrollment
• Providence Health & Services Washington

  dba Providence NEWMG Colville

  • Rural Health Clinic/Center
  • Colville, WA
  • NPI 1255685822

  O20151222000687

  Same enrollment
• Providence Health & Services Washington

  dba PMG PHC Providence Express Care

  • General Practice Physician
  • Spokane, WA
  • NPI 1306391446

  O20040311001453

  Same enrollment
• Providence Health & Services Washington

  dba Providence Family Medicine Chewelah

  • Rural Health Clinic/Center
  • Chewelah, WA
  • NPI 1639892672

  O20040311001453

  Same enrollment
• Providence Heath & Services - Washington

  dba Providence St. Peter Chemical Dependency Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Belfair, WA
  • NPI 1881758472

  O20040311001453

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations (25 of 43)

Practitioners 1,072

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samer Abdulkhalek, MD

  • Nephrology Physician
  • Spokane, WA
  • NPI 1205321262
  Medicare reassignment Care Compare group NPD
• Jamil Abou-Harb, MD

  • Pediatric Gastroenterology Physician
  • Spokane, WA
  • NPI 1891712980
  Medicare reassignment Care Compare group NPD
• Virginie Achim, MD

  • Surgery Physician
  • Spokane, WA
  • NPI 1598085383
  Medicare reassignment Care Compare group NPD
• Rachel Adams, ARNP

  • Family Nurse Practitioner
  • Spokane, WA
  • NPI 1447745286
  Medicare reassignment Care Compare group NPD
• John Scot Aita, M.D.

  • Transplant Hepatology Physician
  • Bellingham, WA
  • NPI 1518956556

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Chayene Peterson Albuquerque, FNP-C

  • Nurse Practitioner
  • Spokane, WA
  • NPI 1285976803
  Medicare reassignment Care Compare group NPD
• Radica Z Alicic, M.D.

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1780667642
  Medicare reassignment Care Compare group NPD
• Mohammad Ali Alkheder, MD

  • Psychiatry Physician
  • Spokane, WA
  • NPI 1477176220

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Caitlin Jane Allen, M.D.

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1124462478
  Medicare reassignment Care Compare group NPD
• Amy J. Anderson, MD

  • Family Medicine Physician
  • Spokane Valley, WA
  • NPI 1306848379
  Medicare reassignment Care Compare group NPD
• Andrew Anderson, D.O.

  • Internal Medicine Physician
  • Spokane, WA
  • NPI 1164803912
  Medicare reassignment Care Compare group NPD
• Bryan Robert Anderson, D.O.

  • Pulmonary Disease Physician
  • Spokane, WA
  • NPI 1578828224

  Internal Medicine

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1194099390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-4114",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "address_2": "MOTHER GAMELIN CENTER 3RD FLOOR",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-474-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-06",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIDENCE MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Providence Health & Services - Washington (Holy Family Maternity Support Services)
• Providence Health & Services - Washington (Providence Holy Family Hospital)
• Providence Health & Services - Washington (Providence St Joseph Care Center)
• Providence Health & Services - Washington (Providence Holy Family Hospital)
• Providence Health & Services Wa
• Providence Health & Services Washington (PMG PHC Providence Express Care)
• Providence Health & Services Washington (Providence Medical Group - Orthopedics South)
• Providence Health & Services Washington
• Providence Health & Services Washington (Providence Spokane Heart Institute)
• Providence Health & Services Washington (Providence Medical Group Lab- Physicians Clinic)

• Pulmonary Disease Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Pulmonary Disease Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.