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Organization

PROVIDENCE HEALTH & SERVICES WASHINGTON

Active
Other names
Providence Centralia 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
914 S SCHEUBER RD, CENTRALIA, WA 98531-9027
(360) 736-2803
Mailing address
909 N. BROADWAY, PBO/CREDENTIALING, EVERETT, WA 98201-1409
(425) 317-0246
(425) 317-0291

Taxonomy

Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3200219
WA
Enumeration date
01/10/2007
Last updated
05/05/2025
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