| Providence Health & Services-wa | |
|
1321 Colby Ave Everett WA 98201-1665 | |
| (425) 261-3968 | |
| (425) 261-3967 |
| Full Name | Providence Health & Services-wa |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 1321 Colby Ave, Everett, Washington |
| Authorized Official Name and Position | Donald Wayne Anderson (ASSIST SECRETARY-ENROLLMENT) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Health & Services-wa Po Box 3369 Portland OR 97208-3369 Ph: () - | Providence Health & Services-wa 1321 Colby Ave Everett WA 98201-1665 Ph: (425) 261-3968 |
| NPI Number | 1033360144 |
|---|---|
| Provider Enumeration Date | 10/07/2008 |
| Last Update Date | 01/11/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033360144 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
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