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Organization
PROVIDENCE HEALTH & SERVICES-WA
Active
Organization
PROVIDENCE HEALTH & SERVICES-WA
Active
Other names
PMG NW WA Monroe OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD W ANDERSON JR. (DIR REIMB REG STRAT/ASST SEC ENROLL)
(425) 358-9786
Entity
Organization
Contact information
Practice address
14692 179TH AVE SE, STE 800, MONROE, WA 98272-1162
(425) 258-7550
(425) 258-7450
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(425) 316-5469
(425) 316-5484
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
NULL
163W00000X
Registered Nurse
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
363LW0102X
Women's Health Nurse Practitioner
—
NULL
363LW0102X
Women's Health Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
NULL
367A00000X
Advanced Practice Midwife
—
—
Other
Enumeration date
07/08/2011
Last updated
08/07/2025
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