NPI 1003367863

Providence Health & Services Washington

Organisation Diagnostic Radiology Physician Lacey, WA

Practice location

Address: 4800 College St SE STE E, Lacey, WA 98503-4389
Phone: (360) 489-2960
Fax: (360) 489-2961
Mailing address: PO Box 31001-4110, Pasadena, CA 91110-4110

Authorised official

Name: Donald Wayne Anderson
Title: Assistant Secretary for Enrollment
Phone: (425) 358-9786

Registered specialties

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X

Other Radiology providers in Washington →

Registry record

NPI: 1003367863
Entity type: Organization
NPI issued: 17 Oct 2016
Record last updated: 13 May 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.