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Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
PMG PHC Providence Express Care
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (DIRECTOR REIMBURSEMENT ADMINISTRATI)
(425) 358-9786
Entity
Organization
Contact information
Practice address
2923 E 29TH AVE, SPOKANE, WA 99223-4811
(509) 626-9820
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
—
NULL
Other
Enumeration date
08/18/2016
Last updated
05/05/2025
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