# PROVIDENCE HEALTH & SERVICES - WA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Regional Medical Center Everett
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750783759
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASSISTANT SECREATRY FOR ENROLLMENT)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 916 PACIFIC AVE, EVERETT, WA 98201-4147
- **Practice address phone:** (425) 258-7361
- **Practice address fax:** (425) 258-7690
- **Mailing address:** 916 PACIFIC AVE, EVERETT, WA 98201-4147
- **Mailing address phone:** (425) 258-7361
- **Mailing address fax:** (425) 258-7690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336I0012X | Institutional Pharmacy | PHAR.CF.00001024 | WA | Yes |

## Other

- **Enumeration date:** 09/22/2014
- **Last updated:** 05/07/2025