OrganizationActive
Providence Health & Services - Washington
NPI 1306201488 · General Practice Physician · Mukilteo, WA
Provider details
- NPI number
- 1306201488
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Donald Anderson, Assistant Secretary - Enrollment(425) 358-9786
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 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
10200 Mukilteo Speedway
Mukilteo, WA 98275-4743
Phone: (425) 525-3194
Street-level locationGet directions
Mailing address
Po Box 3360
Portland, OR 97208-3360
Other names (DBA / former)
- Doing business as
- Providence Physician Group
Registry dates
- Enumerated
- 2015-12-16
- Last updated
- 2025-07-31
- Certified
- 2025-07-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.