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Organization

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Active
Other names
PMG NW WA In Home Primary Care/Clearview
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
1830 BICKFORD AVE, SUITE 211, SNOHOMISH, WA 98290-1749
(360) 668-1820
(360) 668-1825
Mailing address
PO BOX 31001-4114, PASADENA, CA 91110-4114
(425) 358-9786

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
06/01/2011
Last updated
05/14/2025
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