PROVIDENCE HEALTH & SERVICES WASHINGTON NPI 1073744850

NPI Information

  • NPI: 1073744850
  • Provider Name: PROVIDENCE HEALTH & SERVICES WASHINGTON
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • :
  • Address: 2505 OLYMPIC HWY N.
    STE 140
    SHELTON, WA
    ZIP 98584
  • Phone: (360) 432-8692

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NPI Details

PROVIDENCE HEALTH & SERVICES WASHINGTON is a rehabilitation and substance use disorder clinic center in Shelton, WA. PROVIDENCE HEALTH & SERVICES WASHINGTON NPI is 1073744850. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

2505 OLYMPIC HWY N.
STE 140
SHELTON, WA
ZIP 98584-978
Phone: (360) 432-8692
Fax: (360) 432-9902

The provider's authorized official is Donald Wayne Anderson .
The authorized official title is Assistant Secreatry For Enrollment and has the following contact phone number (425) 358-9786.

The enumeration date for this NPI number is 7/28/2009 and was last updated on 5/15/2025.

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
1276400000XRehabilitation, Substance Use Disorder UnitNo
2261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

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: 3/30/2025

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