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Organization

PROVIDENCE HEALTH & SERVICES - WA

Active
Other names
PMG NW WA MC Midwifery
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
12800 BOTHELL EVERETT HWY, SUITE 110, EVERETT, WA 98208-6642
(425) 316-5140
(425) 316-5141
Mailing address
PO BOX 34439, SEATTLE, WA 98124-1439
(425) 316-5439
(425) 316-5484

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
WA
133V00000X
Registered Dietitian
WA
163W00000X
Registered Nurse
WA
367A00000X
Advanced Practice Midwife
Primary
WA

Other

Enumeration date
07/16/2009
Last updated
07/25/2025
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