Organization · Type 2 NPI

Providence Health & Services - Wa

Neurological Surgery Physician · Everett, WA

NPI number 1760633879 Active

Practice location

1330 Rockefeller Ave, Suite 220
Everett, WA 98201-1684

Call (425) 261-4920 Map

Fax (425) 261-4988

Mailing address

PO Box 3360
Portland, OR 97208-3360

Specialties and licenses

Taxonomy	Code	License
Neurological Surgery Physician Primary	207T00000X	None listed
Durable Medical Equipment & Medical Supplies	332B00000X	None listed

Neurological Surgery Physician: A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the opera…

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NPI record

NPI: 1760633879
Entity type: Organization (Type 2)
Issued: Oct 7, 2008
Last updated: May 14, 2025
Status: Active

Other names

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Providence Physician Group - Everett Neuro · doing business as
Providence Physician Group - Everett Neuro · 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 1760633879

Providence Health & Services - Wa's National Provider Identifier is 1760633879, issued on Oct 7, 2008. The primary taxonomy on file is Neurological Surgery Physician (207T00000X), and the practice location is in Everett, WA. The record was last updated on May 14, 2025.