NPIMap

Organization Active NPI

Providence Health & Services - Washington

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Hoquiam, WA
National Provider Identifier
1043374119
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Hospital UnitTaxonomy code 276400000X
Legal business name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Practice address
508 Quarter Eighth Street
Hoquiam, WA 98550
Phone
(360) 533-8813
NPI assigned
Dec 21, 2006
Organization subpart
No

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 701

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311001453 WA Part B Supplier - Clinic/Group Practice 0345139929 Receives reassigned benefits from 946 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations (25 of 56)

940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460

11919 W Sunset Hwy
Ste D
Airway Heights, WA 99001
Phone (509) 474-2650

100 W South Ave
#A
Chewelah, WA 99109

840 S Meyers St
#A
Kettle Falls, WA 99141

4825 SE Bishop Blvd
Ste 140
Pullman, WA 99164

2505 Olympic Hwy N
Shelton, WA 98584

101 W 8th Ave
Ste 4200
Spokane, WA 99204
Phone (509) 474-2730

105 W 8th Ave
Ste 450E
Spokane, WA 99204
Phone (509) 474-6920

551 E Hawthorne Rd
#A
Spokane, WA 99218

212 E Central Ave
Ste 365
Spokane, WA 99208
Phone (509) 435-0793

105 W 8th Ave
Ste 454E
Spokane, WA 99204
Phone (509) 456-8550

101 W 8th Ave
Ste 418
Spokane, WA 99204

1919 S Grand Blvd
Spokane, WA 99203
Phone (509) 747-3081

101 W 8th Ave
Fl 3PSHMC
Spokane, WA 99204

105 W 8th Ave
Ste 4300
Spokane, WA 99204

101 W 8th Ave
Ste 454
Spokane, WA 99204

2933 E 29th Ave
Spokane, WA 99223
Phone (509) 624-5277

624 E Front Ave
Frnt
Spokane, WA 99202

212 E Central Ave
Ste 240
Spokane, WA 99208
Phone (509) 489-7504

105 W 8th Ave
Ste Chg
Spokane, WA 99204

421 S Division St
#A
Spokane, WA 99202

101 W 8th Ave
#3N
Spokane, WA 99204
Phone (509) 474-7500

910 N Washington St
Ste 201
Spokane, WA 99201
Phone (509) 455-4925

105 W 8th Ave
Ste 123C
Spokane, WA 99204
Phone (509) 474-7496

101 W 8th Ave
Ste 1300
Spokane, WA 99204
Phone (509) 474-2444

NPPES NPI Registry

Updated by the provider on May 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donald Wayne Anderson Jr.
Title
Assistant Secreatry for Enrollment
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X Primary

Addresses

Primary practice location

508 Quarter Eighth Street
Hoquiam, WA 98550

Mailing address

909 N Broadway
Pbo/Credentailing
Everett, WA 98201-1409
Phone (425) 317-0246

Other names 1

  • Providence St. Peter Chemical Dependency Center Doing business as

NPI Registry JSON

The complete record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1043374119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 N BROADWAY",
            "address_2": "PBO/CREDENTAILING",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011409",
            "telephone_number": "425-317-0246",
            "fax_number": "425-317-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 QUARTER EIGHTH STREET",
            "city": "HOQUIAM",
            "state": "WA",
            "postal_code": "98550",
            "telephone_number": "360-533-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES - WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECREATRY FOR ENROLLMENT",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence St. Peter Chemical Dependency Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hoquiam, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.