Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
PMG E WA PMP ORTHOPEDICS DME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD W. ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
16528 DESMET CT, SPOKANE VALLEY, WA 99216-3522
(509) 994-8920
(509) 227-7070
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
(509) 474-2072
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
08/14/2014
Last updated
05/05/2025
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