# PROVIDENCE HEALTH & SERVICES - WA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PMG NW WA MC Midwifery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861622557
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 12800 BOTHELL EVERETT HWY, SUITE 110, EVERETT, WA 98208-6642
- **Practice address phone:** (425) 316-5140
- **Practice address fax:** (425) 316-5141
- **Mailing address:** PO BOX 34439, SEATTLE, WA 98124-1439
- **Mailing address phone:** (425) 316-5439
- **Mailing address fax:** (425) 316-5484

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | WA | — |
| 133V00000X | Registered Dietitian | — | WA | — |
| 163W00000X | Registered Nurse | — | WA | — |
| 367A00000X | Advanced Practice Midwife | — | WA | Yes |

## Other

- **Enumeration date:** 07/16/2009
- **Last updated:** 07/25/2025