Organization
PMG NW WA CRANIAL SPINE & JOINT
Active
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
1717 13TH ST, FOURTH FLOOR, EVERETT, WA 98201-1621
(425) 297-6400
Mailing address
1717 13TH ST, FOURTH FLOOR, EVERETT, WA 98201-1621
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60254052
WA
Other
Enumeration date
05/22/2012
Last updated
07/25/2025
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