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Organization

PROVIDENCE HEALTH & SERVICES WASHINGTON

Active
Other names
Providence Centralia Hospital - Physiatry
Organization subpart
No

Provider details

NPI number
Authorized official
DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY FOR ENROLLMENT)
(425) 358-9786
Entity
Organization

Contact information

Practice address
1800 COOKS HILL RD, SUITE E, CENTRALIA, WA 98531-9072
(360) 330-8626
(360) 807-7983
Mailing address
PO BOX 31001 - 4110, PASADENA, CA 91110-4110
(425) 525-6778
(425) 525-6700

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
261QX0100X
Occupational Medicine Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7058589
WA
Enumeration date
07/17/2007
Last updated
03/03/2026
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