Organization
PROVIDENCE HEALTH & SERVICES-WA
Active
Other names
Providence Physician Group- Neurosurgery and Spine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
1330 ROCKEFELLER AVE, SUITE 225, EVERETT, WA 98201-1684
(425) 261-4960
(425) 225-1001
Mailing address
PO BOX 34439, SEATTLE, WA 98124-1439
(425) 525-6652
(425) 525-6700
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
10/26/2010
Last updated
08/07/2025
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