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

Providence Health & Services-Wa

Organization Nutritionist · NPI 1790936185

Providence Health & Services-Wa is a Nutritionist in Everett, Washington. Licensed in Washington. Registered with an NPI since 2008.

Licensed in
WA
In the registry since
2008
Specialties on file
6

Practice location Address checks out

900 Pacific Ave First Fl
Everett, WA 98201-4168
Phone: (425) 258-7311
Fax: (425) 258-7618
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X
Nutritionist Taxonomy 133N00000X
Nutrition Education Nutritionist Taxonomy 133NN1002X
Developmental Disabilities Clinic/Center Taxonomy 261QD1600X (WA)
General Acute Care Hospital Taxonomy 282N00000X · Licence HAC.FS.00000084 (WA)
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1790936185
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Asst Secretary-Enrollment · (425) 358-9786
NPI enumeratedOctober 4, 2008
Last updated in NPPESFebruary 10, 2026
Certification dateFebruary 10, 2026
Mailing addressPo Box 31001-4110, Pasadena, CA 91110-4110

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