Active NPI
Providence Health & Services- Washington
Doing business as PMG NW Wa
- General Practice Physician
- Everett, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- PROVIDENCE HEALTH & SERVICES- WASHINGTON
- Doing business as
- PMG NW Wa
Providence Medical Group Northwest Washington - Practice address
- 900 Pacific Ave
Ste 501
Everett, WA 98201-4168 - Phone
- (425) 258-7550
- Fax
- (425) 258-7450
- NPI assigned
- Oct 15, 2008
- Last updated
- Feb 19, 2026
- Organization subpart
- No
NPPES NPI Registry
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 Secretary of Enrollments
- Phone
- (425) 358-9786
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| General Practice Physician | 208D00000X | Primary | ||
| Physical Therapist | 225100000X |
Addresses
Primary practice location
900 Pacific Ave
Ste 501
Everett, WA 98201-4168
Mailing address
PO Box 31001-4114
Pasadena, CA 91110-4114
Phone (425) 358-9786
Other names 2
- PMG NW WA
- PROVIDENCE MEDICAL GROUP NORTHWEST WASHINGTON
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, OR, CO, AK, CA, MI, MT, HI, NV, MO, FL, NY, DC, TX, ID, MN, AZ, IL, NE, TN, WI, UT, NC, NJ
Enrollment records 24
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081224000111 | WA | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 816 practitioners 34 other NPIs on this enrollment |
| O20190103000011 | OR | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 24 practitioners Practice locations: Portland, OR; Astoria, OR; Beaverton, OR; Bend, OR; Corvallis, OR; Happy Valley, OR; Hood River, OR; Medford, OR… |
| O20190118000527 | CO | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 1 practitioner Practice locations: Frisco, CO |
| O20190131000417 | AK | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 5 practitioners Practice locations: Anchorage, AK |
| O20190204000924 | CA | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 21 practitioners Practice locations: Pico Rivera, CA; Los Angeles, CA; Redlands, CA; Riverside, CA; San Diego, CA; San Jose, CA; Simi Valley, CA; Sylmar, CA… |
| O20200327001316 | MI | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 4 practitioners Practice locations: Hudsonville, MI; Shelby, MI; Saint Clair Shores, MI; Ludington, MI; Ada, MI; Hart, MI |
| O20200420000686 | MT | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 6 practitioners Practice locations: Lolo, MT; Missoula, MT |
| O20201001001126 | HI | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 1 practitioner Practice locations: Honolulu, HI |
| O20201007002636 | NV | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 4 practitioners Practice locations: Reno, NV |
| O20201008000150 | MO | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 1 practitioner Practice locations: Manchester, MO |
| O20201013003509 | FL | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 2 practitioners Practice locations: Miami, FL |
| O20201019000601 | NY | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 3 practitioners Practice locations: Brooklyn, NY; Syosset, NY; White Plains, NY |
| O20201026001461 | DC | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 1 practitioner Practice locations: Bowie, MD |
| O20210427001047 | TX | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 8 practitioners Practice locations: Allen, TX; Friendswood, TX; Frisco, TX; Houston, TX; Irving, TX; Westlake, TX |
| O20220303001998 | ID | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 2 practitioners Practice locations: Boise, ID; Kuna, ID |
| O20230105003266 | MN | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 1 practitioner Practice locations: Minneapolis, MN |
| O20230711003097 | AZ | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 1 practitioner Practice locations: Green Valley, AZ |
| O20240112002258 | IL | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 2 practitioners Practice locations: Oak Brook, IL; Park Ridge, IL |
| O20240617002732 | NE | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 1 practitioner Practice locations: Elkhorn, NE |
| O20240910000833 | TN | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 2 practitioners Practice locations: Memphis, TN |
| O20241009000596 | WI | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 1 practitioner Practice locations: Williams Bay, WI |
| O20250408001693 | UT | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 2 practitioners Practice locations: Hurricane, UT; St George, UT |
| O20250623000461 | NC | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 1 practitioner Practice locations: Huntersville, NC |
| O20251210003497 | NJ | Part B Supplier - Clinic/Group Practice | 8325100480 |
Receives reassigned benefits from 1 practitioner Practice locations: Hillside, NJ |
Other NPIs on the same Medicare enrollment 34
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba PMG NW WA H P Urgent Care
- General Practice Physician
- Mukilteo, WA
- NPI 1003050709
O20081224000111
-
- Neurological Surgery Physician
- Everett, WA
- NPI 1144471533
O20081224000111
-
- Family Medicine Physician
- Everett, WA
- NPI 1255582649
O20081224000111
-
dba Providence Physician Group Harbour Pointe Cardiology
- Cardiovascular Disease Physician
- Mukilteo, WA
- NPI 1669616363
O20081224000111
-
dba Providence Physician Group - Everett Neuro
- Neurological Surgery Physician
- Everett, WA
- NPI 1760633879
O20081224000111
-
dba PMG NW WA MC Midwifery
- Advanced Practice Midwife
- Everett, WA
- NPI 1861622557
O20081224000111
-
dba PMG NW WA MC Walk In Clinic
- General Practice Physician
- Everett, WA
- NPI 1013169507
O20081224000111
-
dba PMG NW WA Marysville Clinic
- Family Medicine Physician
- Marysville, WA
- NPI 1063663458
O20081224000111
-
dba PMG NW WA - Harbour Pointe
- Family Medicine Physician
- Mukilteo, WA
- NPI 1124279237
O20081224000111
-
dba PMG NW WA N Everett Internal Medicine
- Internal Medicine Physician
- Everett, WA
- NPI 1154572253
O20081224000111
-
dba PMG NW WA Monroe Family Medicine
- Family Medicine Physician
- Monroe, WA
- NPI 1225289333
O20081224000111
-
dba PMG NW WA Ever Vascular Surg
- Vascular Surgery Physician
- Everett, WA
- NPI 1225335425
O20081224000111
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D0633805 | PMG NW Wa Pacific OB/GYN | Certificate of waiver | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryLocations (25 of 27)
112 E Main St
Hart, MI 49420
920 Royal Ave
Medford, OR 97504
Phone (541) 732-8400
12800 Bothell Everett Hwy
Ste 110
Everett, WA 98208
Phone (425) 316-5150
12800 Bothell Everett Hwy
Ste 250
Everett, WA 98208
Phone (425) 316-5440
13020 Meridian Ave S
Ste 202
Everett, WA 98208
Phone (425) 357-3700
13020 Meridian Ave S
Ste 203
Everett, WA 98208
Phone (425) 357-3700
13020 Meridian Ave S
Ste 205
Everett, WA 98208
Phone (425) 316-5155
1330 Rockefeller Ave
Ste 220
Everett, WA 98201
Phone (425) 261-4920
1330 Rockefeller Ave
Ste 310
Everett, WA 98201
Phone (425) 261-4925
3216 Norton Ave
Ste 102
Everett, WA 98201
Phone (425) 252-0895
4301 Hoyt Ave
Everett, WA 98203
Phone (425) 317-8025
900 Pacific Ave
Fl 1
Everett, WA 98201
Phone (425) 258-7311
916 Pacific Ave
Fl 7
Everett, WA 98201
Phone (425) 303-6500
12040 NE 128th St
Ste 100
Kirkland, WA 98034
Phone (425) 899-1000
12333 NE 130th Ln
Ste 210
Kirkland, WA 98034
Phone (425) 261-4950
11604 State Ave Ste G
Marysville, WA 98271
1821 Grove St
Marysville, WA 98270
Phone (360) 659-3926
15224 Main St
Ste 303
Mill Creek, WA 98012
Phone (425) 357-1105
15465 179th Ave SE
Monroe, WA 98272
Phone (360) 794-4284
4112 Harbour Pointe Blvd SW
Mukilteo, WA 98275
Phone (425) 343-6334
1801 Lind Ave SW
#9016
Renton, WA 98057
Phone (503) 893-7120
425 Pontius Ave N
Ste 300
Seattle, WA 98109
Phone (206) 320-4000
5300 Tallman Ave NW
#4
Seattle, WA 98107
Phone (206) 297-5100
550 17th Ave
Ste 540
Seattle, WA 98122
Phone (206) 320-2300
1705 Terrace Ave
Snohomish, WA 98290
Phone (360) 568-2168
Practitioners & affiliated clinicians
Practitioners 974
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Hospitalist Physician
- Everett, WA
- NPI 1548235518
-
- Obstetrics & Gynecology Physician
- Centralia, WA
- NPI 1134650138
-
- Internal Medicine Physician
- Everett, WA
- NPI 1003826603
-
- Neurology Physician
- Seattle, WA
- NPI 1891082293
-
- Obstetrics & Gynecology Physician
- Everett, WA
- NPI 1972705762
-
- Psychiatry Physician
- Bellevue, WA
- NPI 1760848873
-
- Emergency Medical Services (Emergency Medicine) Physician
- Everett, WA
- NPI 1982458030
-
- Family Medicine Physician
- Everett, WA
- NPI 1134106867
-
- Clinical Social Worker
- Everett, WA
- NPI 1184477887
-
- Gastroenterology Physician
- Everett, WA
- NPI 1811378235
-
- Family Medicine Physician
- Everett, WA
- NPI 1083714281
-
- Clinical Social Worker
- Seattle, WA
- NPI 1104119908
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224028800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1771459200000",
"number": "1124270715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31001-4114",
"city": "PASADENA",
"state": "CA",
"postal_code": "911104114",
"telephone_number": "425-358-9786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 PACIFIC AVE",
"address_2": "STE 501",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014168",
"telephone_number": "425-258-7550",
"fax_number": "425-258-7450"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROVIDENCE HEALTH & SERVICES- WASHINGTON",
"organizational_subpart": "NO",
"enumeration_date": "2008-10-15",
"last_updated": "2026-02-19",
"certification_date": "2026-02-19",
"status": "A",
"authorized_official_last_name": "ANDERSON",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "WAYNE",
"authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
"authorized_official_telephone_number": "425-358-9786",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "PMG NW WA",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "PMG NW WA",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "PROVIDENCE MEDICAL GROUP NORTHWEST WASHINGTON",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Everett, WA
- Providence Health & Services - Washington (PMG NW WA Physiatry)
- Providence Health & Services - Washington (PMG NW WA MC Family Medicine)
- Providence Health & Services - Washington (PMG NW WA Everett Cardiology)
- Providence Health & Services - Washington (PMG NW WA Reconstructive & Plastic Surgery)
- Providence Health & Services Washington (PMG NW WA Gynecologic Oncology Associates)
- Providence Health & Services-Wa
- Providence Health & Services-Wa (Providence Regional Medical Center Everett)
- Providence Health & Services-Wa (PMG NW WA Pacific Midwifery)
- Providence Health & Services-Wa
- Providence Health & Services-Wa (PMG NW Wa OB GYN Hospitalists)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.