Providence Physician Group

LBN: Providence Health & Services-Wa
Providence Physician Group is an health care organization with primary practice located at 12800 Bothell Everett Hwy Suite 160, Everett WA 98208-6644. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Suppliers / Durable Medical Equipment & Medical Supplies. Allopathic & Osteopathic Physicians / Cardiovascular Disease is the primary health care specialty. Providence Health & Services-Wa can be contacted via phone (425) 316-5490, or through Anderson, Donald Wayne via phone (425) 525-5392.

Contact Information

Primary practice address
12800 Bothell Everett Hwy Suite 160 Everett WA 98208-6644
Phone: (425) 316-5490
Fax: (425) 225-1002
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald Wayne
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1508000449
LBN Legal business name Providence Health & Services-Wa
DBA Doing business as Providence Physician Group
Authorized official Anderson, Donald Wayne
Entity Organization
Organization subpart 1 No
Enumeration date Apr 22nd, 2009
Last updated Apr 1st, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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