Data Notice: All results sourced from the public CMS NPPES NPI Registry (45 CFR Part 162) — for healthcare administrative use only (credentialing, billing, insurance verification). Not for law enforcement or legal proceedings. Not affiliated with CMS, HHS, or the US Government. Verify critical details at npiregistry.cms.hhs.gov. No queries stored.
Export Provider Record NPI 1124279237
Providence Health & Services - Washington
Organization Subpart: NO
Active
NPI Number1124279237
NPI TypeNPI-2 Organization
SpecialtyFamily Medicine
Provider Details
NPI1124279237
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2008-10-07
Last Updated2025-05-12
Authorized OfficialDonald Anderson
ASSISTANT SECRETARY OF ENROLLMENTS
Phone: 4253589786
Mailing AddressPo Box 31001-4114
Pasadena, CA 91110-4114
United States
Phone: (425) 358-9786
📍 View Map
Primary Practice Address4112 Harbour Pointe Blvd Sw, Suite 100
Mukilteo, WA 98275-5457
United States
Phone: (425) 347-6330 | Fax: (425) 347-6335
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No207R00000X – Internal Medicine
No208000000X – Pediatrics
No332B00000X – Durable Medical Equipment & Medical Supplies
Yes207Q00000X – Family Medicine
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About NPI 1124279237

Providence Health & Services - Washington is an organization registered in the CMS NPPES NPI Registry with NPI number 1124279237. The primary specialty listed is Family Medicine. The organization is located in Mukilteo, WA. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2008-10-07. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1124279237?

NPI 1124279237 belongs to Providence Health & Services - Washington, a Family Medicine in Mukilteo, WA. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1124279237 active?

The current status of NPI 1124279237 in the NPPES registry is Active. The record was last updated on 2025-05-12.

What specialty is NPI 1124279237?

NPI 1124279237 is classified under the taxonomy Family Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1124279237?

You can verify NPI 1124279237 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1124279237?

The primary practice address on file for NPI 1124279237 is 4112 Harbour Pointe Blvd Sw, Mukilteo, WA 98275-5457. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1124279237 issued?

NPI 1124279237 was first issued (enumerated) on 2008-10-07. The NPPES record was last updated on 2025-05-12.

Practice Location Map

Providence Health & Services - Washington is located at 4112 Harbour Pointe Blvd Sw, Mukilteo, WA. Use the map below to find directions or verify the practice location.

📍 4112 Harbour Pointe Blvd Sw, Mukilteo, WA 98275-5457  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Providence Health & Services - Washington. All records sourced from the CMS NPPES registry.

Data Verified from CMS NPPES Last synced: 2026-06-29 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162