Organization
PROVIDENCE HEALTH & SERVICES WASHINGTON
Active
Other names
Providence Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
4833 TUMWATER VALLEY DR SE, TUMWATER, WA 98501-4583
(360) 493-4160
Mailing address
PO BOX 3087, PORTLAND, OR 97208-3087
(425) 254-5566
(425) 254-5565
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
10/02/2006
Last updated
05/16/2025
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