NPI 1306201488

Providence Health & Services - Washington

Organisation General Practice Physician Mukilteo, WA

Practice location

Address: 10200 Mukilteo Speedway, Mukilteo, WA 98275-4743
Phone: (425) 525-3194
Mailing address: PO Box 3360, Portland, OR 97208-3360

Authorised official

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

Registered specialties (2)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Washington →

Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261Q00000X

Other Clinic/Center providers in Washington →

Registry record

NPI: 1306201488
Entity type: Organization
NPI issued: 16 Dec 2015
Record last updated: 31 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.