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PROVIDENCE HEALTH & SERVICES WASHINGTON
NPI 1063611408
Clinic/Center in Lacey, WA

Active since July 16, 2007
420 GOLF CLUB RD SE, SUITE 203, LACEY, WA 98503(360) 493-7469(360) 459-2023 Get Directions Write a Review

NPPES record last updated: July 25, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 7, 2025, Oct 31, 2017 (2 updates tracked since 2017).

About Providence Health & Services Washington NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI 1063611408) is a healthcare organization registered as a clinic/center in Lacey, Washington and active in the NPI registry since July 2007. The organization lists Donald Wayne Anderson, Assistant Secretary For Enrollment, as its authorized official.

NPPES Registry Identity

NPI1063611408
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES WASHINGTON
Location Address420 GOLF CLUB RD SE, SUITE 203Lacey, WA 98503-1048
Mailing AddressPo Box 31001-4110Pasadena, CA 91110-4110 · (425) 525-6717 · Fax (425) 525-6700
Phone(360) 493-7469
Fax(360) 459-2023
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary For Enrollment · (425) 358-9786
Enumeration DateJuly 16, 2007
Last NPPES UpdateJuly 25, 20252 updates tracked since enumeration
NPPES CertifiedJuly 25, 2025
✔ NPI 1063611408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in WA · H-159
Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

420 GOLF CLUB RD SE, Lacey, WA 98503
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Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEBORAH K. HALL MD
Pediatrics
420 GOLF CLUB RD SE, SUITE 204
LACEY, WA 98503
Thurston County (360) 493-7469
LAURIE J. DAVIS ARNP
Nurse Practitioner
420 GOLF CLUB RD SE, SUITE 204
LACEY, WA 98503
Thurston County (360) 493-7469
DR. TAMBRA LIN DONOHUE
Psychologist (Clinical)
420 GOLF CLUB RD SE
LACEY, WA 98503
Thurston County (360) 923-1884
JUDITH PRESSON ANP
Nurse Practitioner (Family)
420 GOLF CLUB RD SE, SUITE 203
LACEY, WA 98503
Thurston County (360) 493-7469
MS. LISA GAIL WAHL ARNP
Nurse Practitioner
420 GOLF CLUB RD SE, SUITE 204
LACEY, WA 98503
Thurston County (360) 493-7469

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Health & Services Washington's NPI number?

The NPI number for Providence Health & Services Washington is 1063611408. It was assigned to this organization in the NPPES registry on July 16, 2007.

Where is Providence Health & Services Washington located?

Providence Health & Services Washington is located at 420 Golf Club Rd SE Suite 203, Lacey, WA 98503. The listed phone number is (360) 493-7469.

What is Providence Health & Services Washington's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Providence Health & Services Washington was last updated on July 25, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.