# PROVIDENCE HEALTH & SERVICES - WASHINGTON

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528719184
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 2811 S 102ND ST STE 220, SEATTLE, WA 98168-1869
- **Practice address phone:** (206) 320-4000
- **Practice address fax:** (206) 320-2280
- **Mailing address:** PO BOX 94511, SEATTLE, WA 98124-6811

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QH0002X | Hospice and Palliative Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2022
- **Last updated:** 05/16/2025