Organization · Type 2 NPI

Providence Health & Services- Washington

Family Medicine Physician · Mill Creek, WA

NPI number 1790014504 Active

Practice location

16708 Bothell-Everett Highway, Suite 201
Mill Creek, WA 98012-6345

Call (425) 482-9020 Map

Fax (425) 482-9021

Mailing address

PO Box 3360
Portland, OR 97208-3360

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.

Other family medicine physician providers in Mill Creek

Mill Creek Family Practice PLLCFamily Medicine Physician Mill Creek, WA NPI 1598806770

See all in Mill Creek →

NPI record

NPI: 1790014504
Entity type: Organization (Type 2)
Issued: Dec 8, 2009
Last updated: May 9, 2025
Status: Active

Other names

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PMG NW Wa Mill Creek Commons · doing business as
PMG NW Wa Mill Creek Commons · 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 1790014504

Providence Health & Services- Washington's National Provider Identifier is 1790014504, issued on Dec 8, 2009. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Mill Creek, WA. The record was last updated on May 9, 2025.