Organization · Type 2 NPI

Providence Health & Services Washington

Gynecologic Oncology Physician · Everett, WA

NPI number 1750520516 Active

Practice location

1717 13th Street, Suite 300
Everett, WA 98201-1621

Call (425) 297-5660 Map

Fax (425) 297-5505

Mailing address

PO Box 31001-4114
Pasadena, CA 91110-4114

Specialties and licenses

Taxonomy	Code	License
Gynecologic Oncology Physician Primary	207VX0201X	None listed

Gynecologic Oncology Physician: An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.

NPI record

NPI: 1750520516
Entity type: Organization (Type 2)
Issued: Feb 18, 2009
Last updated: May 9, 2025
Status: Active

Other names

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PMG NW Wa Gynecologic Oncology Associates · doing business as
PMG NW Wa Gynecologic Oncology Associates · doing business as

Authorized official

Donald Wayne 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 1750520516

Providence Health & Services Washington's National Provider Identifier is 1750520516, issued on Feb 18, 2009. The primary taxonomy on file is Gynecologic Oncology Physician (207VX0201X), and the practice location is in Everett, WA. The record was last updated on May 9, 2025.