Organization
PROVIDENCE HEALTH & SERVICES - WA
Active
Other names
PMG NW WA H P Urgent Care
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
4112 HARBOUR POINTE BLVD SW, SUITE100, MUKILTEO, WA 98275-5457
(425) 347-6350
(425) 347-6335
Mailing address
PO BOX 34439, SEATTLE, WA 98124-1439
(425) 316-5469
(425) 316-5484
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
04/24/2009
Last updated
07/25/2025
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