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NPI Code Detail

MEDICARE: PROVIDENCE HEALTH & SERVICES WASHINGTON

MEDICARE: PROVIDENCE HEALTH & SERVICES WASHINGTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1335E00000XProsthetic/Orthotic Supplier
2207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1881059954
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROVIDENCE HEALTH & SERVICES WASHINGTON
Provider Business Mailing Address
First Line : PO BOX 31001-4114
Second Line :
City : PASADENA
State : CA
Zip : 91110-4114
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 212 E CENTRAL AVE
Second Line : SUITE 245
City : SPOKANE
State : WA
Zip : 99208-6291
Country : US
Telephone Number : 509-252-1977
Fax Number :
Authorized Official
Title or Position : ASSISTANT SECRETARY OF ENROLLMENTS
Name : MR. DONALD W. ANDERSON JR.
Credential :
Telephone Number : 425-358-9786
Provider Enumeration Date : 12/16/2015
Last Update Date : 04/27/2026

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Directions to “PROVIDENCE HEALTH & SERVICES WASHINGTON ” Practice Location

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