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Organization

PROVIDENCE HEALTH & SERVICES WASHINGTON

Active
Other names
Providence Marianwood
Organization subpart
No

Provider details

NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization

Contact information

Practice address
3725 PROVIDENCE POINT DR SE, ISSAQUAH, WA 98029-7219
(425) 391-2800
(425) 391-5440
Mailing address
PO BOX 94582, SEATTLE, WA 98124-6882
(425) 391-2800
(425) 391-5440

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1177
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1177
WA
Enumeration date
09/13/2005
Last updated
05/16/2025
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