# PROVIDENCE HEALTH & SERVICES-WA

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

## Provider details

- **NPI number:** 1447547658
- **Authorized official:** MR. DONALD W ANDERSON JR. (DIR REIMB REG STRAT/ASST SEC ENROLL)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 14692 179TH AVE SE, STE 800, MONROE, WA 98272-1162
- **Practice address phone:** (425) 258-7550
- **Practice address fax:** (425) 258-7450
- **Mailing address:** PO BOX 3360, PORTLAND, OR 97208-3360
- **Mailing address phone:** (425) 316-5469
- **Mailing address fax:** (425) 316-5484

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | — | NULL | — |
| 163W00000X | Registered Nurse | — | — | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 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