National Provider Identifier Database

PROVIDENCE HEALTH SERVICES WA
Addiction Medicine

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine


Contact Information

PROVIDENCE HEALTH & SERVICES-WA
1321 COLBY AVE
EVERETT, WA98201-1665
Phone: 425-261-3968
Fax: 425-261-3967
Website:
Specialty Taxonomy Code
* Addiction Medicine 2084A0401X
Psychiatric/Mental Health 363LP0808X

* Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH & SERVICES-WA

NPI Number 1033360144
Legal business name
LBN
PROVIDENCE HEALTH & SERVICES-WA
Authorized official DONALD ANDERSON - (ASSIST SECRETARY-ENROLLMENT)
Entity Organization
Organization subpart No
Enumeration date 10/07/2008
Last updated 05/13/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

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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