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Organization

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Active
Other names
PMG NW WA MC Walk In Clinic
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
12800 BOTHELL EVERETT HWY, SUITE 120, EVERETT, WA 98208-6642
(425) 316-5150
(425) 225-1006
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
(425) 358-9786

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
208000000X
Pediatrics Physician
208D00000X
General Practice Physician
Primary
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Enumeration date
10/16/2008
Last updated
07/24/2025
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