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
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 491-9480
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
208M00000X
Hospitalist Physician
—
—
282N00000X
General Acute Care Hospital
Primary
313007977
WA
Other
Enumeration date
07/16/2007
Last updated
05/15/2025
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