Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
Providence St. Peter Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD ANDERSON JR. (ASST CORP SEC FOR ENROLLMENTS)
(425) 525-5392
Entity
Organization
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 491-9480
(360) 493-5858
Mailing address
PO BOX 3505, PORTLAND, OR 97208-3505
(360) 491-9480
(360) 493-4277
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3302601
—
WA
05
—
HS60IP
—
AL
01
—
ST0232
REGENCE
WA
Enumeration date
08/25/2006
Last updated
06/21/2018
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