Organization · Type 2 NPI

Providence Health & Services Washington

Family Medicine Physician · Colville, WA

NPI number 1083968879 Active

Practice location

1200 E Columbia Ave
Colville, WA 99114-3354

Call (509) 474-2072 Map

Mailing address

PO Box 31001-4114
Pasadena, CA 91110-4114

Other practice locations

143 Garden Homes Dr, Colville, WA 99114-9229 · (509) 684-3701
100 W South Ave, Chewelah, WA 99109-9684 · (509) 684-3701

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

53 other providers at this address

Other family medicine physician providers in Colville

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NPI record

NPI: 1083968879
Entity type: Organization (Type 2)
Issued: Nov 1, 2012
Last updated: May 5, 2025
Status: Active

Other names

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Providence North East Washington Medical Group · doing business as
Providence North East Washington Medical Group · doing business as

Authorized official

Mr. Donald W Anderson
Assistant Secretary of Enrollments
(425) 358-9786

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1083968879

Providence Health & Services Washington's National Provider Identifier is 1083968879, issued on Nov 1, 2012. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Colville, WA. The record was last updated on May 5, 2025.