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Contact Information

PROVIDENCE HEALTH & SERVICES-WA
1321 COLBY AVE
EVERETT, WA98201-1665
 Phone: 425-261-3968
 Fax: 425-261-3967
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH SERVICES WA · (Female)

NPI Number 1033360144
Status Active
Credentials
Entity Individual
Enumeration date 10/07/2008
Last updated 05/13/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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