PROVIDENCE HEALTH & SERVICES - WASHINGTON
NPI 1306201488
General Practice in Mukilteo, WA

Q: What is Providence Health & Services - Washington's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since December 16, 2015

10200 MUKILTEO SPEEDWAY, MUKILTEO, WA 98275(425) 525-3194 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 26, 2017, Dec 16, 2015 (2 updates tracked since 2015).

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About Providence Health & Services - Washington NPPES

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

PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI 1306201488), doing business as Providence Physician Group, is a healthcare organization registered as a general practice in Mukilteo, Washington and active in the NPI registry since December 2015. The organization lists Donald Wayne Anderson, Assistant Secretary - Enrollment, as its authorized official.

NPPES Registry Identity

NPI1306201488

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - WASHINGTON

Location Address10200 MUKILTEO SPEEDWAYMukilteo, WA 98275-4743

Mailing AddressPo Box 3360Portland, OR 97208-3360

Phone(425) 525-3194

Organization SubpartNo

Authorized OfficialDonald Wayne AndersonAssistant Secretary - Enrollment · (425) 358-9786

Enumeration DateDecember 16, 2015

Last NPPES UpdateJuly 31, 20252 updates tracked since enumeration

NPPES CertifiedJuly 31, 2025

✔ NPI 1306201488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedClinic/CenterTaxonomy 261Q00000X

10200 MUKILTEO SPEEDWAY, Mukilteo, WA 98275

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Other Names 1

Doing Business AsProvidence Physician Group

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Other Providers at the Same Location NPPES 12

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

JANE A JACOBSON ARNP

Nurse Practitioner (Family)