National Provider Identifier Database

PROVIDENCE HEALTH SERVICES WASHINGTON
Cardiovascular Disease

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.


Contact Information

PROVIDENCE HEALTH & SERVICES - WASHINGTON
107 SW 1ST ST
SUITE 104
ENTERPRISE, OR97828
Phone: 509-838-7711
Fax:
Website:
Specialty Taxonomy Code
* Cardiovascular Disease 207RC0000X

* Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH & SERVICES - WASHINGTON

NPI Number 1144536269
Legal business name
LBN
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Authorized official DONALD ANDERSON - (ASSISTANT SECRETARY OF ENROLLMENTS)
Entity Organization
Organization subpart No
Enumeration date 08/26/2010
Last updated 08/01/2025 - About 10 months 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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