# PROVIDENCE HEALTH & SERVICES WASHINGTON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PMG PHC Providence Express Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306391446
- **Authorized official:** DONALD W ANDERSON JR. (DIRECTOR REIMBURSEMENT ADMINISTRATI)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 2923 E 29TH AVE, SPOKANE, WA 99223-4811
- **Practice address phone:** (509) 626-9820
- **Mailing address:** PO BOX 421, LIBERTY LAKE, WA 99019-0421

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 08/18/2016
- **Last updated:** 05/05/2025