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PROVIDENCE HEALTH & SERVICES WASHINGTON
NPI 1689805509
Clinic/Center - Rehabilitation, Substance Use Disorder in Lacey, WA

Active since July 28, 2009
4800 COLLEGE ST SE, LACEY, WA 98503(360) 456-7575(360) 493-5088 Get Directions Write a Review

NPPES record last updated: May 15, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 15, 2025, Mar 7, 2025, Oct 30, 2017 (3 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 1689805509) is a healthcare organization registered as a rehabilitation, substance use disorder in Lacey, Washington and active in the NPI registry since July 2009. The organization lists Donald Wayne Anderson, Assistant Secretary For Enrollment, as its authorized official.

NPPES Registry Identity

NPI1689805509
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NamePROVIDENCE HEALTH & SERVICES WASHINGTON
Location Address4800 COLLEGE ST SELacey, WA 98503-4389
Mailing AddressPo Box 31001-4110Pasadena, CA 91110-4110 · (425) 525-6778 · Fax (425) 525-6700
Phone(360) 456-7575
Fax(360) 493-5088
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary For Enrollment · (425) 358-9786
Enumeration DateJuly 28, 2009
Last NPPES UpdateMay 15, 20253 updates tracked since enumeration
NPPES CertifiedMay 15, 2025
✔ NPI 1689805509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
Also ListedRehabilitation, Substance Use Disorder UnitTaxonomy 276400000X
4800 COLLEGE ST SE, Lacey, WA 98503
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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 ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Providence Health & Services Washington is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

184

Medicare enrollment records show 184 clinicians reassign Medicare billing to Providence Health & Services Washington, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 96 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 29

Internal Medicine30
Nurse Practitioner21
Family Practice12
Obstetrics/Gynecology11
Pulmonary Disease10
Cardiovascular Disease (Cardiology)9
Hospice/Palliative Care9
Urology9
21 other specialties73

Nearest to this location (20)

See all 184
Tara Brooks, LMHC
Mental Health Counselor
NPI 1245472182
4800 COLLEGE ST SE
Lacey, WA 98503
(360) 456-7575
✔ PECOSSame address
Sarah Lagrange, LICSW
Clinical Social Worker
NPI 1477210607
4800 COLLEGE ST SE
Lacey, WA 98503
(360) 456-7575
✔ PECOSSame address
James Piotrowski
Mental Health Counselor
NPI 1568108512
4800 COLLEGE ST SE
Lacey, WA 98503
(564) 233-8217
✔ PECOSSame address
Danny Tran, DO
Psychiatry
NPI 1982058780
4800 COLLEGE ST SE
Lacey, WA 98503
(360) 493-7060
✔ PECOS✔ Accepts MedicareSame address
Jason Arnold, LICSW
Clinical Social Worker
NPI 1174758700
4800 COLLEGE ST SE STE F
Lacey, WA 98503
(360) 458-7575
✔ PECOSSame address
Rebecca Broderick, ACNPC-AG, BSN, RN
Nurse Practitioner
NPI 1629755657
677 WOODLAND SQUARE LOOP SE STE D7
Lacey, WA 98503
(703) 447-6155
✔ PECOS✔ Accepts Medicare2.7 mi
Anish Konde, M.D.
Hematology/Oncology
NPI 1417343971
4525 3RD AVE SE STE 200
Lacey, WA 98503
(360) 754-3934
✔ PECOS✔ Accepts Medicare2.8 mi
Mijung Lee, MD
Medical Oncology
NPI 1093970048
4525 3RD AVE SE STE 200
Lacey, WA 98503
(360) 754-3934
✔ PECOS✔ Accepts Medicare2.8 mi
John O'boyle, M.D.
Gynecological Oncology
NPI 1306808381
4525 3RD AVE SE STE 200
Lacey, WA 98503
(360) 754-3934
✔ PECOS✔ Accepts Medicare2.8 mi
Louise May, M.D.
Vascular Surgery
NPI 1982961173
128 LILLY RD NE STE 205
Olympia, WA 98506
(360) 493-7444
✔ PECOS✔ Accepts Medicare3.2 mi
Patrick Murray, M.D.
Urology
NPI 1548606346
149 LILLY RD NE
Olympia, WA 98506
(360) 486-6772
✔ PECOS✔ Accepts Medicare3.3 mi
Haroon Yousaf, MD
Interventional Cardiology
NPI 1871731364
3620 ENSIGN RD NE STE B
Olympia, WA 98506
(360) 884-0052
✔ PECOS✔ Accepts Medicare3.4 mi
Mordechai Groner, M.D.
Infectious Disease
NPI 1427347764
3525 ENSIGN RD NE STE F
Olympia, WA 98506
(360) 493-4001
✔ PECOS✔ Accepts Medicare3.4 mi
Dustin Engelken, MD
Pulmonary Disease
NPI 1174683007
500 LILLY RD NE STE 201
Olympia, WA 98506
(360) 413-8272
✔ PECOS✔ Accepts Medicare3.5 mi
Kawandus Bennett, MD
Internal Medicine
NPI 1912945718
413 LILLY RD NE
Olympia, WA 98506
(360) 493-4083
✔ PECOS✔ Accepts Medicare3.5 mi
Nina Andersen, DO
Hospice/Palliative Care
NPI 1912535576
413 LILLY RD NE
Olympia, WA 98506
(360) 486-6402
✔ PECOS✔ Accepts Medicare3.5 mi
Khaled Darwesh, MD
Hospitalist
NPI 1265963805
413 LILLY RD NE
Olympia, WA 98506
(360) 493-4083
✔ PECOS✔ Accepts Medicare3.5 mi
Juliette Erickson, MD
Family Practice
NPI 1851489660
413 LILLY RD NE
Olympia, WA 98506
(360) 486-6402
✔ PECOS✔ Accepts Medicare3.5 mi
Joyce Gilbert, MD
Pediatric Medicine
NPI 1174515993
413 LILLY RD NE
Olympia, WA 98506
(360) 493-7469
✔ PECOS3.5 mi
Stephen Lykins, MD
Psychiatry
NPI 1194805390
413 LILLY RD NE
Olympia, WA 98506
(360) 493-7064
✔ PECOS✔ Accepts Medicare3.5 mi
See all 184 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 1689805509. It was assigned to this organization in the NPPES registry on July 28, 2009.

Where is Providence Health & Services Washington located?

Providence Health & Services Washington is located at 4800 College St SE, Lacey, WA 98503. The listed phone number is (360) 456-7575.

What is Providence Health & Services Washington's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Is Providence Health & Services Washington enrolled in Medicare?

Yes. Providence Health & Services Washington is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Providence Health & Services Washington?

According to the CMS Revalidation Reassignment List (October 2026 release), 184 clinicians in 29 Medicare specialties reassign their Medicare billing to Providence Health & Services Washington. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Internal Medicine (30), Nurse Practitioner (21) and Family Practice (12). Of these, 5 practice at this address and 96 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Providence Health & Services Washington accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Providence Health & Services Washington as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Providence Health & Services Washington was last updated on May 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.