Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
Providence St Peter Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECREATRY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
2505 OLYMPIC HWY N., STE 140, SHELTON, WA 98584-2978
(360) 432-8692
(360) 432-9902
Mailing address
PO BOX 34439, SEATTLE, WA 98124-1439
(425) 525-6778
(425) 525-6700
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
Other
Enumeration date
07/28/2009
Last updated
05/15/2025
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