Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PROVIDENCE HEALTH & SERVICES- WASHINGTON
Active
Organization
PROVIDENCE HEALTH & SERVICES- WASHINGTON
Active
Other names
PMG NW WA, PROVIDENCE MEDICAL GROUP NORTHWEST WASHINGTON
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
900 PACIFIC AVE, STE 501, EVERETT, WA 98201-4168
(425) 258-7550
(425) 258-7450
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
(425) 358-9786
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
Other
Enumeration date
10/15/2008
Last updated
02/19/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers