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Contact Information

PROVIDENCE HEALTH & SERVICES - WA
916 PACIFIC AVE
EVERETT, WA98201-4147
 Phone: 425-258-7361
 Fax: 425-258-7690
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH & SERVICES - WA

NPI Number 1750783759
LBN Legal business name PROVIDENCE HEALTH & SERVICES - WA
Authorized official DONALD ANDERSON - (ASSISTANT SECREATRY FOR ENROLLMENT)
Entity Organization
Organization subpart 1 No
Enumeration date 09/22/2014
Last updated 05/07/2025 - More than a year ago
Identifiers
WA License # PHAR.CF.00001024
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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