Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
Providence Centralia Hospital - Anesthesia Group
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
914 S SCHEUBER RD, CENTRALIA, WA 98531-9027
(360) 736-2803
Mailing address
PO BOX 34439, SEATTLE, WA 98124-1439
(425) 525-6778
(425) 525-6700
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
000057
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28551
L&I
WA
05
—
7117484
—
WA
01
—
8901099
L&I CRIME VICTIMS
WA
Enumeration date
07/17/2007
Last updated
05/05/2025
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