Organization · Type 2 NPI

Providence Health & Services- Washington

General Practice Physician · Everett, WA

NPI number 1124270715 Active

Practice location

900 Pacific Ave, Ste 501
Everett, WA 98201-4168

Call (425) 258-7550 Map

Fax (425) 258-7450

Mailing address

PO Box 31001-4114
Pasadena, CA 91110-4114

Specialties and licenses

Taxonomy	Code	License
Clinical Social Worker	1041C0700X	None listed
General Practice Physician Primary	208D00000X	None listed
Physical Therapist	225100000X	None listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

94 other providers at this address

Other general practice physician providers in Everett

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NPI record

NPI: 1124270715
Entity type: Organization (Type 2)
Issued: Oct 15, 2008
Last updated: Feb 19, 2026
Status: Active

Other names

<unavail>
PMG NW Wa · doing business as
PMG NW Wa · doing business as
Providence Medical Group Northwest Washington · doing business as

Authorized official

Donald Wayne Anderson
Assistant Secretary of Enrollments
(425) 358-9786

Verify this record

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 1124270715

Providence Health & Services- Washington's National Provider Identifier is 1124270715, issued on Oct 15, 2008. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Everett, WA. The record was last updated on Feb 19, 2026.