PROVIDENCE HEALTH & SERVICES - WA NPI 1225335425

NPI Information

PROVIDENCE HEALTH & SERVICES - WA is a vascular surgery surgery in Everett, WA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. PROVIDENCE HEALTH & SERVICES - WA NPI is 1225335425. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pmg Nw Wa Ever Vascular Surg.

The provider's business location address is:

1330 ROCKEFELLER AVE
STE 520
EVERETT, WA
ZIP 98201-684
Phone: (425) 287-5200
Fax: (425) 287-5210

The provider's authorized official is Donald Wayne Anderson .
The authorized official title is Secretary For Enrollment and has the following contact phone number (425) 525-5392.

The enumeration date for this NPI number is 2/24/2011 and was last updated on 4/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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