Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Other names
Providence Medical Group Southeast Washington Neurosurgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Authorized official
DONALD W. ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
301 W POPLAR ST STE 50, WALLA WALLA, WA 99362-2800
(509) 522-1030
(509) 526-8402
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
H-050
WA
Other
Enumeration date
11/05/2008
Last updated
05/07/2025
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