Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
PROVIDENCE NORTHEAST WASHINGTON MEDICAL GROUP - KETTLE FALLS
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W. ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
840 S MEYERS ST, KETTLE FALLS, WA 99141-7005
(509) 685-7848
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
(509) 685-7848
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/05/2012
Last updated
05/05/2025
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