Providence Health & Services - Washington

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

Legal business name

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Practice address

15918 E Euclid Ave
Spokane Valley, WA 99216-1815

Phone

(509) 924-1826

Fax

(509) 924-6258

NPI assigned

Jan 17, 2013

Organization subpart

No

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 Enrollments

Phone

(425) 358-9786

Specialties & licenses 6

Addresses

Other names 2

• PROVIDENCE INFUSION AND PHARMACY SERVICES Doing business as
• Providence Infusion and Pharm Serv Doing business as

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

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

• Providence Health & Services - Washington

  • Home Infusion Therapy Pharmacy
  • Tukwila, WA
  • NPI 1285687749

  1951429752

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Providence Health & Services - Washington

  • Home Infusion Therapy Pharmacy
  • Tukwila, WA
  • NPI 1285687749

  O20210326001947

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Providence Health Services - Washington3 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.

• Providence Health & Services - Washington

  • Home Infusion Therapy Pharmacy
  • Tukwila, WA
  • NPI 1285687749
  NPD tax ID
• Providence Health & Services Washington

  • Long Term Care Pharmacy
  • Tukwila, WA
  • NPI 1720121346
  NPD tax ID

Locations

Practitioners 6

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

• Olivia Wooliver Jones, RD

  • Registered Dietitian
  • Spokane Valley, WA
  • NPI 1043072382
  NPD
• Simone R Pappalardo, RD

  • Registered Dietitian
  • Spokane Valley, WA
  • NPI 1154094134
  NPD
• Briley Cariagain Peters, RD

  • Registered Dietitian
  • Spokane Valley, WA
  • NPI 1043052921
  NPD
• Kjell Rasmussen, RD, RDN, MS

  • Registered Dietitian
  • Spokane Valley, WA
  • NPI 1790504124
  NPD
• Bryan Stahlberg, RDN

  • Registered Dietitian
  • Spokane Valley, WA
  • NPI 1174268064
  NPD
• Gracey Mae Neal

  • Student in an Organized Health Care Education/Training Program
  • Spokane Valley, WA
  • NPI 1629991658
  NPD (past)

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1710225271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24292",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981240292",
            "telephone_number": "509-924-1826",
            "fax_number": "509-924-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15918 E EUCLID AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161815",
            "telephone_number": "509-924-1826",
            "fax_number": "509-924-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES - WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Pharmacology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIDENCE INFUSION AND PHARMACY SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Infusion and Pharm Serv",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Infusion and Pharm Serv",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Infusion Therapy Pharmacy in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Home Infusion Therapy Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.