# PROVIDENCE HEALTH & SERVICES WASHINGTON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PROVIDENCE MOUNT ST VINCENT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952386369
- **Authorized official:** DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 4831 35TH AVE SW, SEATTLE, WA 98126-2709
- **Practice address phone:** (206) 937-3700
- **Practice address fax:** (206) 938-8999
- **Mailing address:** 4831 35TH AVE SW, SEATTLE, WA 98126-2709
- **Mailing address phone:** (206) 937-3700
- **Mailing address fax:** (206) 938-8999

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | BH-198 | WA | — |
| 314000000X | Skilled Nursing Facility | 77 | WA | Yes |

## Other

- **Enumeration date:** 12/08/2005
- **Last updated:** 05/16/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41-07702 | — | WA |