Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
Providence Infusion and Pharmacy Services
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
3333 S 120TH PL STE 100B, TUKWILA, WA 98168-5134
(425) 687-4400
(425) 687-4401
Mailing address
PO BOX 24292, SEATTLE, WA 98124-0292
(425) 687-4400
(425) 687-4401
Taxonomy
Speciality
Code
Description
License number
State
208U00000X
Clinical Pharmacology Physician
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
CF00056548
WA
3336L0003X
Long Term Care Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
02/14/2007
Last updated
05/16/2025
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