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Providence Health Services, Inc

NPI 1285208009ActiveOrganization· Physiological Laboratory· Washington, DC

Physiological Laboratory in Washington, District of Columbia, registered in NPPES in May 2021. The authorized official on file is Michael Dunwell, Coord Credentialing. Enrolled in Medicare as part b supplier - independent diagnostic testing facility (idtf).

Overview

NPI1285208009
StatusActive
Entity typeOrganization
NPI issuedMay 17, 2021
Last updated in NPPESMay 6, 2022
Certified by providerMay 6, 2022

Specialties and licenses

TaxonomyCodeLicenseState
Physiological Laboratory Primary293D00000X——
Clinic/Center, Magnetic Resonance Imaging (MRI)261QM1200X——
Clinic/Center, Radiology261QR0200X——
Clinic/Center, Radiology, Mammography261QR0206X——
Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier335V00000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Independent Diagnostic Testing Facility (Idtf) (DC)

Medicare sources and data years

Other Physiological Laboratory providers in Washington

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