Providence Health & Services - Washington

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Doing business as

Providence ElderPlace - Seattle

Practice address

1801 Lind Ave SW Ste W2-17
Renton, WA 98057-3368

Phone

(206) 320-5325

NPI assigned

Aug 24, 2022

Last updated

May 16, 2025By the provider in NPPES

Organization subpart

No

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 Enrollment

Phone

(425) 358-9786

Specialties & licenses 1

Addresses

Other names 1

• Providence ElderPlace - Seattle Doing business as

Locations

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1891414785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 LIND AVE SW STE W2-17",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573368",
            "telephone_number": "206-320-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 LIND AVE SW STE W2-17",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980573368",
            "telephone_number": "206-320-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTH & SERVICES - WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "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": "W",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY ENROLLMENT",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence ElderPlace - Seattle",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence ElderPlace - Seattle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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.