# PROVIDENCE HEALTH & SERVICES WASHINGTON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Marianwood
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598750895
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 3725 PROVIDENCE POINT DR SE, ISSAQUAH, WA 98029-7219
- **Practice address phone:** (425) 391-2800
- **Practice address fax:** (425) 391-5440
- **Mailing address:** PO BOX 94582, SEATTLE, WA 98124-6882
- **Mailing address phone:** (425) 391-2800
- **Mailing address fax:** (425) 391-5440

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1177 | WA | Yes |

## Other

- **Enumeration date:** 09/13/2005
- **Last updated:** 05/16/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1177 | — | WA |