1. Home
  2. Directory
  3. Washington
  4. Olympia
  5. Physician Assistant
  6. NPI Profile

PROVIDENCE HEALTH & SERVICES WASHINGTON
NPI 1851574750
Physician Assistant - Surgical in Olympia, WA

Active since December 13, 2007
413 LILLY RD NE, OLYMPIA, WA 98506(360) 491-9480 Get Directions Write a Review

NPPES record last updated: May 15, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 15, 2025, Mar 7, 2025, Oct 31, 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 1851574750) is a healthcare organization registered as a surgical in Olympia, Washington and active in the NPI registry since December 2007. The organization lists Donald Wayne Anderson, Assistant Secretary For Enrollment, as its authorized official.

NPPES Registry Identity

NPI1851574750
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NamePROVIDENCE HEALTH & SERVICES WASHINGTON
Location Address413 LILLY RD NEOlympia, WA 98506-5133
Mailing AddressPo Box 31001-4110Pasadena, CA 91110-4110 · (425) 525-6717 · Fax (425) 525-6700
Phone(360) 491-9480
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary For Enrollment · (425) 358-9786
Enumeration DateDecember 13, 2007
Last NPPES UpdateMay 15, 20253 updates tracked since enumeration
NPPES CertifiedMay 15, 2025
✔ NPI 1851574750 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
413 LILLY RD NE, Olympia, WA 98506
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

DR. JEFFREY HOWARD MD
Emergency Medicine
413 LILLY RD NE
OLYMPIA, WA 98506
Thurston County (360) 491-9480
DR. PENELOPE ANNE GOODE M.D.
Emergency Medicine
413 LILLY RD NE, OLYMPIA EMERGENCY SERVICES
OLYMPIA, WA 98506
Thurston County (360) 493-4554
MR. URIEL JIMENEZ SANCHEZ
Pharmacist
413 LILLY RD NE
OLYMPIA, WA 98506
Thurston County (360) 493-7179
DANIEL HU
Pharmacist
413 LILLY RD NE
OLYMPIA, WA 98506
Thurston County (360) 493-5438
RAFFY JATAMOSA
Registered Nurse
413 LILLY RD NE
OLYMPIA, WA 98506
Thurston County (360) 491-9480
CHANH TAM NGUYEN
Student in an Organized Health Care Education/Training Program
413 LILLY RD NE
OLYMPIA, WA 98506
Thurston County (360) 493-7525
SUSAN A DERRY MD
Emergency Medicine
413 LILLY RD NE, MSDDH09
OLYMPIA, WA 98506
Thurston County (360) 918-0119
AMORY E.W. BALLANTINE LICSW
Social Worker (Clinical)
413 LILLY RD NE
OLYMPIA, WA 98506
Thurston County (360) 491-9480

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 1851574750. It was assigned to this organization in the NPPES registry on December 13, 2007.

Where is Providence Health & Services Washington located?

Providence Health & Services Washington is located at 413 Lilly Rd NE, Olympia, WA 98506. The listed phone number is (360) 491-9480.

What is Providence Health & Services Washington's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

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 15 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.