OrganizationActive
Providence Health & Services Washington
NPI 1023563897 · General Practice Physician · College Place, WA
Provider details
- NPI number
- 1023563897
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary of Enrollments(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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.
Practice location
1705 Se Meadowbrook Blvd
Suite 2
College Place, WA 99324-1756
Phone: (509) 987-2450
Street-level locationGet directions
Mailing address
Po Box 32
Liberty Lake, WA 99019-0032
Other names (DBA / former)
- Doing business as
- Providence Health & Services Washington (pmg Se Wa) - Express Care
Registry dates
- Enumerated
- 2016-08-22
- Last updated
- 2025-05-06
- Certified
- 2025-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.