OrganizationActive
Providence Health & Services Washington
NPI 1083968879 · Family Medicine Physician · Colville, WA
Provider details
- NPI number
- 1083968879
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary of Enrollments(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
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
1200 E Columbia Ave
Colville, WA 99114-3354
Phone: (509) 474-2072
Street-level locationGet directions
Mailing address
Po Box 31001-4114
Pasadena, CA 91110-4114
Other names (DBA / former)
- Doing business as
- Providence North East Washington Medical Group
- Doing business as
- Providence North East Washington Medical Group
Additional practice locations (2)
- 100 W South AveChewelah, WA 99109-9684Phone: (509) 684-3701
- 143 Garden Homes DrColville, WA 99114-9229Phone: (509) 684-3701
Registry dates
- Enumerated
- 2012-11-01
- Last updated
- 2025-05-05
- Certified
- 2025-05-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.