# PROVIDENCE HEALTH & SERVICES WASHINGTON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Centralia Hospital - Anesthesia Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043419393
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 914 S SCHEUBER RD, CENTRALIA, WA 98531-9027
- **Practice address phone:** (360) 736-2803
- **Mailing address:** PO BOX 34439, SEATTLE, WA 98124-1439
- **Mailing address phone:** (425) 525-6778
- **Mailing address fax:** (425) 525-6700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 000057 | WA | Yes |

## Other

- **Enumeration date:** 07/17/2007
- **Last updated:** 05/05/2025