Nurse Practitioner, Pediatrics
PROVIDENCE HEALTH & SERVICES-WA
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1790936185 · enumerated 2008-10-04 · record updated 2026-02-10. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: DONALD ANDERSON, Asst Secretary-Enrollment · (425) 358-9786
Addresses and phones
- Mailing address PO BOX 31001-4110, PASADENA, CA, 91110-4110 Google Maps Apple Maps OpenStreetMap
- Practice location 900 PACIFIC AVE, FIRST FLOOR, EVERETT, WA, 98201-4168 (425) 258-7311 Fax (425) 258-7618 Google Maps Apple Maps OpenStreetMap
Specialties
- Nurse Practitioner 363L00000X
- General Acute Care Hospital 282N00000X · License HAC.FS.00000084 WA
- Nutritionist 133N00000X
- Nutritionist, Nutrition, Education 133NN1002X
- Clinic/Center, Developmental Disabilities 261QD1600X
- Nurse Practitioner, Pediatrics 363LP0200X · Primary
In this directory
Locations and evidence
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Practice location
EVERETT, WA, 982014168
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.