OrganizationActive
Providence Health & Services Washington
NPI 1063611408 · Clinic/Center · Lacey, WA
Providence Health & Services Washington is a Clinic/Center organization in Lacey, WA (NPI 1063611408).
Provider details
- NPI number
- 1063611408
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary for Enrollment(425) 358-9786
- License
- H-159 (WA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 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
420 Golf Club Rd Se
Suite 203
Lacey, WA 98503-1048
Phone: (360) 493-7469
Fax: (360) 459-2023
Street-level locationGet directions
Mailing address
Po Box 31001-4110
Pasadena, CA 91110-4110
Registry dates
- Enumerated
- 2007-07-16
- Last updated
- 2025-07-25
- Certified
- 2025-07-25
Frequently asked questions
- What is Providence Health & Services Washington's NPI number?
- Providence Health & Services Washington's National Provider Identifier (NPI) is 1063611408, 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 Clinic/Center (Ambulatory Health Care Facilities).
- Where is Providence Health & Services Washington located?
- Providence Health & Services Washington's practice location on file with NPPES is 420 Golf Club Rd Se, Lacey, WA 98503-1048.
- 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) 493-7469.
- 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 (1063611408) is active in the NPPES registry as of the last update on 2025-07-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.