Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Providence Health & Services - Wa

Organization Family Medicine Physician · NPI 1003050709

Providence Health & Services - Wa is a Family Medicine Physician in Mukilteo, Washington. Registered with an NPI since 2009.

In the registry since
2009
Specialties on file
5
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Practice location Address checks out

4112 Harbour Pointe Blvd SW SUITE100
Mukilteo, WA 98275-5457
Phone: (425) 347-6350
Fax: (425) 347-6335
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Pediatrics Physician Taxonomy 208000000X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1003050709
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Pmg Nw Wa H P Urgent Care
NPI enumeratedApril 24, 2009
Last updated in NPPESJuly 25, 2025
Certification dateJuly 25, 2025
Mailing addressPo Box 34439, Seattle, WA 98124-1439

Other providers in Mukilteo