Providence Health & Services - Wa

NPI #1003050709 in Mukilteo, Washington

Provider Information

NPI Number: 1003050709
Entity Type: Organization
Organization Name: Providence Health & Services - Wa
Primary Specialty: General Practice
Enumeration Date: Apr 24, 2009
Last Updated: Jul 25, 2025

Practice Location

Address: 4112 HARBOUR POINTE BLVD SW
Address 2: SUITE100
City: Mukilteo
State: Washington
ZIP Code: 98275-5457
Phone: (425) 347-6350

Authorized Official

Name: DONALD WAYNE ANDERSON JR.
Title: ASSISTANT SECRETARY OF ENROLLMENTS
Phone: (425) 358-9786

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Internal Medicine	207R00000X
Pediatrics	208000000X
Durable Medical Equipment & Medical Supplies	332B00000X
General Practice	208D00000X	Primary

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Providence Health & Services - Washington	General Practice	Mukilteo	AI Deep Dive

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