# PROVIDENCE HEALTH & SERVICES WASHINGTON

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

## Provider details

- **NPI number:** 1801989587
- **Authorized official:** MR. DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 4833 TUMWATER VALLEY DR SE, TUMWATER, WA 98501-4583
- **Practice address phone:** (360) 493-4160
- **Mailing address:** PO BOX 3087, PORTLAND, OR 97208-3087
- **Mailing address phone:** (425) 254-5566
- **Mailing address fax:** (425) 254-5565

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 05/16/2025