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

Providence Health & Services - Washington

Organization Dermatology Physician · NPI 1912158023

Providence Health & Services - Washington is a Dermatology Physician in Everett, Washington. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
6
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Practice location Address checks out

12800 Bothell Everett Hwy Ste 260
Everett, WA 98208-6642
Phone: (425) 316-5080
Fax: (425) 316-5025
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X
Dermatology Physician Taxonomy 207N00000X
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Dermatopathology Physician Taxonomy 207ND0900X
Pediatric Dermatology Physician Taxonomy 207NP0225X
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1912158023
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Pmg Nw Wa Reconstructive & Plastic Surgery; Pmg Nw Wa Reconstructive & Plastic Surgery
NPI enumeratedOctober 7, 2008
Last updated in NPPESMay 9, 2025
Certification dateMay 9, 2025
Mailing addressPo Box 31001-4114, Pasadena, CA 91110-4114

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