| Providence Health & Services Washington | |
|
413 Lilly Rd Ne Olympia WA 98506-5133 | |
| (360) 491-9480 | |
| (360) 483-5858 |
| Full Name | Providence Health & Services Washington |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 413 Lilly Rd Ne, Olympia, Washington |
| Authorized Official Name and Position | Donald Wayne Anderson (ASSISTANT SECRETARY FOR ENROLLMENT) |
| Authorized Official Contact | 4253589786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Health & Services Washington Po Box 31001-4110 Pasadena CA 91110-4110 Ph: (425) 317-0246 | Providence Health & Services Washington 413 Lilly Rd Ne Olympia WA 98506-5133 Ph: (360) 491-9480 |
| NPI Number | 1508877689 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 05/13/2025 |
| Certification Date | 05/13/2025 |
| Medicare PECOS PAC ID | 7719873496 |
|---|---|
| Medicare Enrollment ID | O20041112000546 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508877689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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