Organization
PROVIDENCE HEALTH & SERVICES-WA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASST SECRETARY-ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1509 CALIFORNIA ST, EVERETT, WA 98201-3540
(425) 297-5770
(425) 259-5831
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/04/2008
Last updated
05/07/2025
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