Providence Health & Services- Washington

NPI #1790014504 in Mill Creek, Washington

Provider Information

NPI Number: 1790014504
Entity Type: Organization
Organization Name: Providence Health & Services- Washington
Primary Specialty: Family Medicine
Enumeration Date: Dec 8, 2009
Last Updated: May 9, 2025

Practice Location

Address: 16708 BOTHELL-EVERETT HIGHWAY
Address 2: SUITE 201
City: Mill Creek
State: Washington
ZIP Code: 98012-6345
Phone: (425) 482-9020

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	Primary

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