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
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(360) 456-7575
(360) 493-5088
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110
(425) 525-6778
(425) 525-6700
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
Other
Enumeration date
07/28/2009
Last updated
05/15/2025
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