Providence Medical Group Southwest Washington

LBN: Providence Health & Services Washington
Providence Medical Group Southwest Washington is an health care organization with primary practice located at 525 Lilly Rd Ne , Olympia WA 98506. The organization recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Adult Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Providence Health & Services Washington can be contacted via phone (360) 793-7230, or through Anderson, Donald Wayne via phone (425) 525-5392.

Contact Information

Primary practice address
525 Lilly Rd Ne Olympia WA 98506
Phone: (360) 793-7230
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Donald Wayne
Phone: (425) 525-5392

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X
Allopathic & Osteopathic Physicians / Dermatology 207N00000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1174744304
LBN Legal business name Providence Health & Services Washington
DBA Doing business as Providence Medical Group Southwest Washington
Authorized official Anderson, Donald Wayne
Entity Organization
Organization subpart 1 No
Enumeration date May 2nd, 2007
Last updated Sep 22nd, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174744304 NPPES
Washington Other 0062287 L&I
Washington Other 8915131 L&I

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