Organization
PROVIDENCE HEALTH & SERVICES - WA
Active
Other names
Providence Physician Group - Everett Neuro
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
1330 ROCKEFELLER AVE, SUITE 220, EVERETT, WA 98201-1684
(425) 261-4920
(425) 261-4988
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(503) 215-0700
(425) 276-3215
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
10/07/2008
Last updated
05/14/2025
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