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

Providence Health & Services- Washington

Organization Family Medicine Physician · NPI 1790014504

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

In the registry since
2009

Practice location Address checks out

16708 Bothell-Everett Hwy Ste 201
Mill Creek, WA 98012-6345
Phone: (425) 482-9020
Fax: (425) 482-9021
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1790014504
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Pmg Nw Wa Mill Creek Commons; Pmg Nw Wa Mill Creek Commons
NPI enumeratedDecember 8, 2009
Last updated in NPPESMay 9, 2025
Certification dateMay 9, 2025
Mailing addressPo Box 3360, Portland, OR 97208-3360

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