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Organization

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Active
Other names
PROVIDENCE HOSPICE & HOME CARE OF SNOHOMISH COUNTY
Organization subpart
No

Provider details

NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASST. SECRETARY ENROLLMENT)
(425) 525-5392
Entity
Organization

Contact information

Practice address
1615 75TH ST SW STE 210, EVERETT, WA 98203-6293
(425) 261-4800
Mailing address
PO BOX 94502, SEATTLE, WA 98124-6802
(425) 261-4800

Taxonomy

Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
251G00000X
Community Based Hospice Care Agency

Other

Enumeration date
01/23/2023
Last updated
01/25/2023
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