NPIMap

Organization Active NPI

Providence Health & Services Washington

  • Rehabilitation Clinic/Center
  • Tumwater, WA
National Provider Identifier
1801989587
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PROVIDENCE HEALTH & SERVICES WASHINGTON
Practice address
4833 Tumwater Valley Dr SE
Tumwater, WA 98501-4583
Phone
(360) 493-4160
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

4833 Tumwater Valley Dr SE
Tumwater, WA 98501-4583

Mailing address

PO Box 3087
Portland, OR 97208-3087
Phone (425) 254-5566

Other practice location 1

91 SW Chehalis Ave
Chehalis, WA 98532-1934
Phone (360) 330-8850

Other names 1

  • Providence Physical Therapy Other name

National Provider Directory

National Provider Directory

Locations

1809 Cooks Hill Rd
Centralia, WA 98531
Phone (360) 330-8626

1800 Cooks Hill Rd
Ste D
Centralia, WA 98531
Phone (360) 330-8844

91 SW Chehalis Ave
Chehalis, WA 98532
Phone (360) 330-8850

91 SW Chehalis Ave
Ste 104
Chehalis, WA 98532
Phone (360) 330-8626

4833 Tumwater Valley Dr SE
#150
Olympia, WA 98501

4833 Tumwater Valley Dr SE
Ste 1
Olympia, WA 98501

4833 Tumwater Valley Dr SE
Ste 150
Tumwater, WA 98501
Phone (360) 493-4160

4841 Tumwater Valley Dr SE
Tumwater, WA 98501

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1801989587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3087",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083087",
            "telephone_number": "425-254-5566",
            "fax_number": "425-254-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4833 TUMWATER VALLEY DR SE",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985014583",
            "telephone_number": "360-493-4160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "91 SW Chehalis Ave",
            "address_purpose": "LOCATION",
            "city": "Chehalis",
            "state": "WA",
            "postal_code": "985321934",
            "country_code": "US",
            "telephone_number": "360-330-8850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "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_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Physical Therapy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Providence Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tumwater, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.