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Organization

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Active
Other names
PMG NW WA CRANIAL SPINE AND JOINT CLINIC
Organization subpart
No

Provider details

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

Contact information

Practice address
1717 13TH ST, SUITE 401, EVERETT, WA 98201-1621
(425) 297-6400
(425) 297-6405
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
(425) 358-9786

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
207X00000X
Orthopaedic Surgery Physician

Other

Enumeration date
04/05/2011
Last updated
05/12/2025
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