PROVIDENCE HEALTH & SERVICES-WA NPI 1790936185

NPI Information

NPI: 1790936185
Provider Name: PROVIDENCE HEALTH & SERVICES-WA
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

Address:
900 PACIFIC AVE
FIRST FLOOR
EVERETT, WA
ZIP 98201
Phone: (425) 258-7311
Get Directions

PROVIDENCE HEALTH & SERVICES-WA is a pediatrics nurse practitioner in Everett, WA. PROVIDENCE HEALTH & SERVICES-WA NPI is 1790936185. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

900 PACIFIC AVE
FIRST FLOOR
EVERETT, WA
ZIP 98201-168
Phone: (425) 258-7311
Fax: (425) 258-7618

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

The enumeration date for this NPI number is 10/4/2008 and was last updated on 1/11/2018.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	133N00000X	Nutritionist				No
2	133NN1002X	Nutritionist	Nutrition, Education			No
3	261QD1600X	Clinic/Center	Developmental Disabilities		WASHINGTON	No
4	282N00000X	General Acute Care Hospital		HAC.FS.00000084	WASHINGTON	No
5	363L00000X	Nurse Practitioner				No
6	363LP0200X	Nurse Practitioner	Pediatrics			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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