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 SECREATRY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
914 S SCHEUBER RD, CENTRALIA, WA 98531-9027
(360) 736-2803
Mailing address
909 N BROADWAY, PBO/CREDENTIALING, EVERETT, WA 98201-1409
(425) 317-0246
(425) 317-0291
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Enumeration date
10/11/2006
Last updated
05/05/2025
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