NPIMap

Organization Active NPI

Providence Health & Services - Washington

Doing business as Providence Infusion and Pharmacy Services

  • Home Infusion Therapy Pharmacy
  • Tukwila, WA
National Provider Identifier
1285687749
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
License
PHAR.CF.60389608 Issued in WA
Legal business name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Doing business as
Providence Infusion and Pharmacy Services
Practice address
3333 S 120TH PL Ste 100
Tukwila, WA 98168-5134
Phone
(425) 687-4400
Fax
(425) 687-4401
NPI assigned
May 18, 2006
Last updated
Feb 25, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Authorized official

Name
Donald W Anderson Jr.
Title
Assistant Secretary of Enrollments
Phone
(425) 358-9786

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
Pharmacy 333600000X NU
Clinical Pharmacology Physician 208U00000X NU
Home Infusion Therapy Pharmacy 3336H0001X PHAR.CF.60389608 WA Primary

Addresses

Primary practice location

3333 S 120TH PL Ste 100
Tukwila, WA 98168-5134

Mailing address

3333 S 120TH PL
Suite 100
Tukwila, WA 98168-5134
Phone (425) 687-4400

Other identifiers 1

IdentifierTypeStateIssuer
1006822MedicaidWA

Other names 1

  • Providence Infusion and Pharmacy Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments
Home infusion therapy
Medicare-enrolled home infusion therapy supplier

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930064760 WA DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 1951429752 Practice locations: Tukwila, WA
O20210326001947 WA Part B Supplier - Home Infusion Therapy Supplier 1951429752 1 other NPI on this enrollment
Practice locations: Tukwila, WA; Spokane Valley, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Providence Health Service-3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15918 E Euclid Ave
Spokane Valley, WA 99216
Phone (509) 924-1826

3333 S 120th Pl
Ste 10
Tukwila, WA 98168

3333 S 120th Pl
Ste 100
Tukwila, WA 98168
Phone (425) 687-4400

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771977600000",
    "number": "1285687749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 S 120TH PL",
            "address_2": "SUITE 100",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981685134",
            "telephone_number": "425-687-4400",
            "fax_number": "425-687-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 S 120TH PL STE 100",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981685134",
            "telephone_number": "425-687-4400",
            "fax_number": "425-687-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES - WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY OF ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.60389608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006822",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Infusion and Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Infusion and Pharmacy Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; 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.