PROVIDENCE HEALTH & SERVICES WASHINGTON NPI 1851574750

NPI Information

NPI: 1851574750
Provider Name: PROVIDENCE HEALTH & SERVICES WASHINGTON
Classification: Physician Assistant - 363AS0400X
Entity Type: Organization

Specialization: Surgical

Address:
413 LILLY RD NE
OLYMPIA, WA
ZIP 98506
Phone: (360) 491-9480
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PROVIDENCE HEALTH & SERVICES WASHINGTON is a surgical physician assistant in Olympia, WA. PROVIDENCE HEALTH & SERVICES WASHINGTON NPI is 1851574750. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

413 LILLY RD NE
OLYMPIA, WA
ZIP 98506-133
Phone: (360) 491-9480

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

The enumeration date for this NPI number is 12/13/2007 and was last updated on 10/31/2017.

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	363AS0400X	Physician Assistant	Surgical			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	8901337	OTHER	WASHINGTON	L&I CRIME VICTIMS
2	129210	OTHER	WASHINGTON	L&I
3	G115117400	MEDICARE PIN	WASHINGTON
4	7135932	MEDICAID	WASHINGTON

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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