Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
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
525 LILLY RD NE, OLYMPIA, WA 98506-5101
(360) 486-6402
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/16/2015
Last updated
05/15/2025
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