PROVIDENCE HEALTH & SERVICES- WASHINGTON
NPI 1790014504
Family Medicine in Mill Creek, WA
About Providence Health & Services- Washington NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROVIDENCE HEALTH & SERVICES- WASHINGTON (NPI 1790014504), doing business as Pmg Nw Wa Mill Creek Commons, is a healthcare organization registered as a family medicine in Mill Creek, Washington and active in the NPI registry since December 2009. The organization lists Donald Wayne Anderson, Assistant Secretary Of Enrollments, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Group Practice 1
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
702Medicare enrollment records show 702 clinicians reassign Medicare billing to Providence Health & Services- Washington, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 199 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 49
Nearest to this location (20)
See all 702Mill Creek, WA 98012
Mill Creek, WA 98012
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 1790014504. It was assigned to this organization in the NPPES registry on December 8, 2009. The provider is doing business as PMG NW WA Mill Creek Commons.
Where is Providence Health & Services- Washington located?
Providence Health & Services- Washington is located at 16708 Bothell-Everett Highway Suite 201, Mill Creek, WA 98012. The listed phone number is (425) 482-9020.
What is Providence Health & Services- Washington's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
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), 702 clinicians in 49 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 Nurse Practitioner (108), Internal Medicine (90) and Family Practice (63). Of these, 2 practice at this address and 199 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Providence Health & Services- Washington was last updated on May 9, 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.
# Providence Health & Services- Washington · NPI 1790014504
Family Medicine organization in Mill Creek, Washington. Organization record, active in the CMS NPPES registry since December 8, 2009.
## Identity
- **NPI:** 1790014504 (Entity type: Organization)
- **Enumerated:** December 8, 2009
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** PMG NW WA Mill Creek Commons (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Donald Anderson, ASSISTANT SECRETARY OF ENROLLMENTS
## Practice location
- **Address:** 16708 BOTHELL-EVERETT HIGHWAY, SUITE 201, Mill Creek, WA 98012-6345
- **Phone:** (425) 482-9020 · **Fax:** (425) 482-9021
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 702 clinicians in 49 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (108), Internal Medicine (90), Family Practice (63); 2 practice at this address and 199 within 10 miles; [full list](https://npiprofile.com/npi/1790014504/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 9, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1790014504) · Data from the CMS NPPES public registry.