Organization
PROVIDENCE HEALTH & SERVICES-WA
Active
Other names
PMG NW WA OB GYN HOSPITALISTS
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
900 PACIFIC AVE, SUITE 501, EVERETT, WA 98201-4147
(425) 259-3108
(425) 258-7450
Mailing address
PO BOX 34439, SEATTLE, WA 98124-1439
(425) 316-5469
(425) 316-5484
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
09/16/2009
Last updated
08/05/2025
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