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Organization

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Active
Other names
Providence SMMC Multi-Specialty DME
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization

Contact information

Practice address
301 W POPLAR ST, SUITE 210, WALLA WALLA, WA 99362-2858
(509) 522-5825
(509) 529-3512
Mailing address
PO BOX 31001 - 4110, PASADENA, CA 91110-4110
(509) 522-5906
(509) 522-5789

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
HAC.FS00000050
WA
207Y00000X
Otolaryngology Physician
HAC.FS.00000050
WA

Other

Enumeration date
04/27/2009
Last updated
03/06/2026
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