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 1215431697

Providence Health & Services Washington is a Clinic/Center in Lacey, Washington. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

4800 College St SE
Lacey, WA 98503-4389
Phone: (360) 493-7567
Fax: (360) 412-6468
Show map & directions

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

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1215431697
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Medical Group Sw Wa - Mdpp; Providence Medical Group Sw Wa - Mdpp
NPI enumeratedMarch 21, 2018
Last updated in NPPESMay 12, 2025
Certification dateMay 12, 2025
Mailing addressPo Box 31001-4114, Pasadena, CA 91110-4114

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