Organization · Type 2 NPI

Providence Health & Services - Wa

Cardiovascular Disease Physician · Mukilteo, WA

NPI number 1669616363 Active

Practice location

4112 Harbour Pointe Blvd SW, Suite 100
Mukilteo, WA 98275-5457

Call (425) 347-6330 Map

Fax (425) 347-6335

Mailing address

PO Box 34439
Seattle, WA 98124-1439

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Cardiovascular Disease Physician Primary	207RC0000X	None listed
Durable Medical Equipment & Medical Supplies	332B00000X	None listed

Cardiovascular Disease Physician: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

10 other providers at this address

NPI record

NPI: 1669616363
Entity type: Organization (Type 2)
Issued: Apr 24, 2009
Last updated: Jul 25, 2025
Status: Active

Other names

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Providence Physician Group Harbour Pointe Cardiology · doing business as

Authorized official

Donald Wayne Anderson
Assistant Secretary for Enrollment
(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 1669616363

Providence Health & Services - Wa's National Provider Identifier is 1669616363, issued on Apr 24, 2009. The primary taxonomy on file is Cardiovascular Disease Physician (207RC0000X), and the practice location is in Mukilteo, WA. The record was last updated on Jul 25, 2025.