Providence Health & Services Washington

NPI #1063611408 in Lacey, Washington

Provider Information

NPI Number: 1063611408
Entity Type: Organization
Organization Name: Providence Health & Services Washington
Primary Specialty: Clinic/Center
Enumeration Date: Jul 16, 2007
Last Updated: Jul 25, 2025

Practice Location

Address: 420 GOLF CLUB RD SE
Address 2: SUITE 203
City: Lacey
State: Washington
ZIP Code: 98503-1048
Phone: (360) 493-7469

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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