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 SECRETARY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
914 S SCHEUBER RD, CENTRALIA, WA 98531
(360) 736-2803
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105
PREMERA BLUE CROSS
WA
01
—
PR5896
REGENCE IP PROVIDER NUMBE
WA
01
—
PR9896
REGENCE OP PROVIDER NUMBE
WA
Enumeration date
10/18/2006
Last updated
05/05/2025
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