NPI 1003050709

Providence Health & Services - Wa

Organisation General Practice Physician Mukilteo, WA

Practice location

Address: 4112 Harbour Pointe Blvd SW Suite100, Mukilteo, WA 98275-5457
Phone: (425) 347-6350
Fax: (425) 347-6335
Mailing address: PO Box 34439, Seattle, WA 98124-1439

Authorised official

Name: Donald Wayne Anderson
Title: Assistant Secretary of Enrollments
Phone: (425) 358-9786

Registered specialties (5)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Washington →

Family Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

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Internal Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207R00000X

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Pediatrics Physician

Allopathic & Osteopathic Physicians Taxonomy 208000000X

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Durable Medical Equipment & Medical Supplies

Suppliers Taxonomy 332B00000X

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Registry record

NPI: 1003050709
Entity type: Organization
NPI issued: 24 Apr 2009
Record last updated: 25 Jul 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.