NPIMap

Organization Active NPI

Providence Heath & Services - Washington

Doing business as Providence St. Peter Chemical Dependency Center

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Belfair, WA
National Provider Identifier
1881758472
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 HEATH & SERVICES - WASHINGTON
Doing business as
Providence St. Peter Chemical Dependency Center
Practice address
24070 NE Highway 3
Belfair, WA 98528
Phone
(360) 277-0523
NPI assigned
Dec 20, 2006
Last updated
May 13, 2025By the provider in NPPES
Organization subpart
No

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

24070 NE Highway 3
Belfair, WA 98528

Mailing address

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

Other names 1

  • Providence St. Peter Chemical Dependency Center Doing business as

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1881758472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 N BROADWAY",
            "address_2": "PBO/CREDENTIALING",
            "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": "24070 NE HIGHWAY 3",
            "city": "BELFAIR",
            "state": "WA",
            "postal_code": "98528",
            "telephone_number": "360-277-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEATH & SERVICES - WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "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 Belfair, 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.