PROVIDENCE HEALTH & SERVICES - WASHINGTON NPI 1124279237

NPI Information

  • NPI: 1124279237
  • Provider Name: PROVIDENCE HEALTH & SERVICES - WASHINGTON
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • :
  • CLIA Number: 50D0721425
  • Address: 4112 HARBOUR POINTE BLVD SW
    SUITE 100
    MUKILTEO, WA
    ZIP 98275
  • Phone: (425) 347-6330

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NPI Details

PROVIDENCE HEALTH & SERVICES - WASHINGTON is a family medicine in Mukilteo, WA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. PROVIDENCE HEALTH & SERVICES - WASHINGTON NPI is 1124279237. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

4112 HARBOUR POINTE BLVD SW
SUITE 100
MUKILTEO, WA
ZIP 98275-457
Phone: (425) 347-6330
Fax: (425) 347-6335

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

The CLIA number assigned to this NPI record is 50D0721425 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/7/2008 and was last updated on 5/12/2025.

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
1207R00000XInternal MedicineNo
2208000000XPediatricsNo
3332B00000XDurable Medical Equipment & Medical SuppliesNo
4207Q00000XFamily MedicineYes

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: 11/21/2025

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