Providence Health & Services Washington
NPI 1003367863 · Diagnostic Radiology Physician · Lacey, WA
Enrolled with Medicare as Part B Supplier - Independent Diagnostic Testing Facility (idtf) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Providence Health & Services Washington is a Diagnostic Radiology Physician organization in Lacey, WA (NPI 1003367863).
Provider details
- NPI number
- 1003367863
- Entity type
- Organization
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary for Enrollment(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
9 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
1,158 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| X-Ray of Chest, 2 Views71046 | 313 | $24 |
| X-Ray of Knee, 3 Views73562 | 119 | $32 |
| X-Ray of Shoulder, Minimum of 2 Views73030 | 94 | $26 |
| X-Ray of Lower and Sacral Spine, 2-3 Views72100 | 93 | $30 |
| X-Ray of Hand, Minimum of 3 Views73130 | 74 | $29 |
| X-Ray of Hip, 2-3 Views73502 | 73 | $38 |
| X-Ray of Foot, Minimum of 3 Views73630 | 54 |
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Providence St Peter Hospital Diagnostic Imaging Lacey
Registry dates
- Enumerated
- 2016-10-17
- Last updated
- 2025-05-13
- Certified
- 2025-05-13
Frequently asked questions
- What is Providence Health & Services Washington's NPI number?
- Providence Health & Services Washington's National Provider Identifier (NPI) is 1003367863, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Providence Health & Services Washington?
- Providence Health & Services Washington is classified in the NPPES registry as Diagnostic Radiology Physician (Allopathic & Osteopathic Physicians).
- Where is Providence Health & Services Washington located?
- Providence Health & Services Washington's practice location on file with NPPES is 4800 College St Se Ste E, Lacey, WA 98503-4389.
- What is Providence Health & Services Washington's phone number?
- The practice phone number listed in the NPPES registry for Providence Health & Services Washington is (360) 489-2960.
- Does Providence Health & Services Washington accept Medicare?
- Providence Health & Services Washington is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Providence Health & Services Washington?
- The authorized official listed on Providence Health & Services Washington's NPPES record is Donald Anderson, Assistant Secretary for Enrollment. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Providence Health & Services Washington's NPI active?
- Yes — Providence Health & Services Washington's NPI (1003367863) is active in the NPPES registry as of the last update on 2025-05-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.