Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
Providence Medical Group Southwest Washington
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1018 CAPITOL WAY S STE 300, OLYMPIA, WA 98501-1212
(360) 486-6508
(360) 570-2077
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
(360) 486-6508
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
05/22/2017
Last updated
05/12/2025
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