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Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
Providence Community Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
225 STATE AVE NE, OLYMPIA, WA 98501-6951
(360) 486-6400
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110
(360) 486-6400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
313007977
WA
103T00000X
Psychologist
313007977
WA
103TC0700X
Clinical Psychologist
313007977
WA
104100000X
Social Worker
313007977
WA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/08/2016
Last updated
05/13/2025
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