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

Providence Health & Services Washington

Organization Clinic/Center · NPI 1063611408

Providence Health & Services Washington is a Clinic/Center in Lacey, Washington. Licensed in Washington. Registered with an NPI since 2007.

Licensed in
WA
In the registry since
2007

Practice location Address checks out

420 Golf Club Rd SE Ste 203
Lacey, WA 98503-1048
Phone: (360) 493-7469
Fax: (360) 459-2023
Show map & directions

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

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X · Licence H-159 (WA)

Record details

NPI number1063611408
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary For Enrollment · (425) 358-9786
NPI enumeratedJuly 16, 2007
Last updated in NPPESJuly 25, 2025
Certification dateJuly 25, 2025
Mailing addressPo Box 31001-4110, Pasadena, CA 91110-4110

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