Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Other names
Providence St Peter Chemical Dependency Center
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
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(360) 456-7575
(360) 493-5088
Mailing address
909 N BROADWAY, PBO/CREDENTIALING, EVERETT, WA 98201-1409
(425) 317-0246
(425) 317-0291
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
—
—
Other
Enumeration date
08/08/2006
Last updated
07/25/2025
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