Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
Providence Medical Group - Orthopedics South
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
820 S MCCLELLAN ST STE 118, SPOKANE, WA 99204-2446
(509) 838-7100
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
05/14/2021
Last updated
05/05/2025
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