Organization
PROVIDENCE HEALTH & SERVICES-WASHINGTON
Active
Other names
PMG NW WA Cardiovascular and Thoracic Surgery
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
1330 ROCKEFELLER AVENUE, SUITE 400, EVERETT, WA 98201-1676
(425) 261-4950
(425) 261-4951
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
(425) 358-9786
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
09/30/2010
Last updated
05/09/2025
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