# PROVIDENCE HEALTH & SERVICES-WA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PMG NW WA Pacific Midwifery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134370240
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 916 PACIFIC AVE, 7TH FLOOR, EVERETT, WA 98201-4147
- **Practice address phone:** (425) 303-6500
- **Practice address fax:** (425) 303-6550
- **Mailing address:** PO BOX 3360, PORTLAND, OR 97208-3360
- **Mailing address phone:** (866) 399-2983

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 133V00000X | Registered Dietitian | — | NULL | — |
| 133V00000X | Registered Dietitian | — | — | — |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | — |
| 364SW0102X | Women's Health Clinical Nurse Specialist | — | NULL | — |
| 364SW0102X | Women's Health Clinical Nurse Specialist | — | — | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | Yes |
| 367A00000X | Advanced Practice Midwife | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2008
- **Last updated:** 08/05/2025