Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Other names
Providence Infusion and Pharmacy Services
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
3333 S 120TH PL STE 100, TUKWILA, WA 98168-5134
(425) 687-4400
(425) 687-4401
Mailing address
3333 S 120TH PL, SUITE 100, TUKWILA, WA 98168-5134
(425) 687-4400
(425) 687-4401
Taxonomy
Speciality
Code
Description
License number
State
208U00000X
Clinical Pharmacology Physician
—
—
251F00000X
Home Infusion Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PHAR.CF.60389608
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006822
—
WA
Enumeration date
05/18/2006
Last updated
02/25/2026
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