Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Other names
Providence St Mary Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
401 W POPLAR ST, WALLA WALLA, WA 99362-2846
(509) 897-3320
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110
(509) 897-3320
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
H-050
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008478
L&I STATE
WA
Enumeration date
10/02/2008
Last updated
05/07/2025
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