Providence Health & Services- Washington
NPI 1124270715 · General Practice Physician · Everett, WA
Provider details
- NPI number
- 1124270715
- 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
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
- Physical Therapist225100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
Mailing address
Other names (DBA / former)
- Doing business as
- Pmg Nw Wa
- Doing business as
- Pmg Nw Wa
- Doing business as
- Providence Medical Group Northwest Washington
Registry dates
- Enumerated
- 2008-10-15
- Last updated
- 2026-02-19
- Certified
- 2026-02-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.