PROVIDENCE HEALTH & SERVICES - WASHINGTON

EVERETT, WA
NPI1912158023
Doing Business AsPMG NW WA RECONSTRUCTIVE & PLASTIC SURGERY
Entity TypeOrganization
Authorized ContactDONALD WAYNE ANDERSON
Assistant Secretary Of Enrollments
425-358-9786
Organization Subpart ?No
Primary Taxonomy208200000X Plastic Surgery
Additional Taxonomies207N00000X Dermatology
207ND0101X Dermatology, MOHS-Micrographic Surgery
207ND0900X Dermatology, Dermatopathology
207NP0225X Dermatology, Pediatric Dermatology
207NS0135X Dermatology, Procedural Dermatology
Enumeration Date2008-10-07
Last Update Date2025-05-09
Business Address
PROVIDENCE HEALTH & SERVICES - WASHINGTON
12800 BOTHELL EVERETT HWY SUITE 260
EVERETT, WA 98208-6642
Phone number: 425-316-5080
Mailing Address
PROVIDENCE HEALTH & SERVICES - WASHINGTON
PO BOX 31001-4114
PASADENA, CA 91110-4114
Phone number: 425-358-9786