# PROVIDENCE HEALTH & SERVICES-WA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PMG NW WA OB GYN HOSPITALISTS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255664652
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 900 PACIFIC AVE, SUITE 501, EVERETT, WA 98201-4147
- **Practice address phone:** (425) 259-3108
- **Practice address fax:** (425) 258-7450
- **Mailing address:** PO BOX 34439, SEATTLE, WA 98124-1439
- **Mailing address phone:** (425) 316-5469
- **Mailing address fax:** (425) 316-5484

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 208M00000X | Hospitalist Physician | — | NULL | Yes |
| 208M00000X | Hospitalist Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/16/2009
- **Last updated:** 08/05/2025