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Organization
PROVIDENCE HEALTH & SERVICES- WASHINGTON
Active
Organization
PROVIDENCE HEALTH & SERVICES- WASHINGTON
Active
Other names
PMG NW WA Mill Creek Commons
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
16708 BOTHELL-EVERETT HIGHWAY, SUITE 201, MILL CREEK, WA 98012-6345
(425) 482-9020
(425) 482-9021
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 399-2983
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/08/2009
Last updated
05/09/2025
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