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PROVIDENCE HEALTH & SERVICES - WA NPI 1912158023


NPI Information

NPI: 1912158023
Provider Name: PROVIDENCE HEALTH & SERVICES - WA

Doing Business As: PMG NW WA RECONSTRUCTIVE & PLASTIC SURGERY

Classification: Plastic Surgery - 208200000X
Entity Type: Organization
Address:
12800 BOTHELL EVERETT HWY
SUITE 260
EVERETT, WA
ZIP 98208
Phone: (425) 316-5080
Get Directions

PROVIDENCE HEALTH & SERVICES - WA is a plastic surgery in Everett, WA. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. PROVIDENCE HEALTH & SERVICES - WA NPI is 1912158023. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pmg Nw Wa Reconstructive & Plastic Surgery.

The provider's business location address is:

12800 BOTHELL EVERETT HWY
SUITE 260
EVERETT, WA
ZIP 98208-642
Phone: (425) 316-5080
Fax: (425) 316-5025

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

The enumeration date for this NPI number is 10/7/2008 and was last updated on 3/1/2021.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyNo
2207ND0101XDermatologyMOHS-Micrographic SurgeryNo
3207ND0900XDermatologyDermatopathologyNo
4207NP0225XDermatologyPediatric DermatologyNo
5207NS0135XDermatologyProcedural DermatologyNo
6208200000XPlastic SurgeryYes

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

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