Plastic Surgery
PROVIDENCE HEALTH & SERVICES - WASHINGTON
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 Plan acceptance stays unpublished until the practice reports it.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 1912158023 · enumerated 2008-10-07 · record updated 2025-05-09. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: DONALD ANDERSON, ASSISTANT SECRETARY OF ENROLLMENTS · (425) 358-9786
Other names: PMG NW WA RECONSTRUCTIVE & PLASTIC SURGERY
Addresses and phones
- Practice location 12800 BOTHELL EVERETT HWY, SUITE 260, EVERETT, WA, 98208-6642 (425) 316-5080 Fax (425) 316-5025 Google Maps Apple Maps OpenStreetMap
- Mailing address PO BOX 31001-4114, PASADENA, CA, 91110-4114 (425) 358-9786 Google Maps Apple Maps OpenStreetMap
Specialties
- Dermatology 207N00000X
- Dermatology, MOHS-Micrographic Surgery 207ND0101X
- Dermatology, Dermatopathology 207ND0900X
- Dermatology, Pediatric Dermatology 207NP0225X
- Dermatology, Procedural Dermatology 207NS0135X
- Plastic Surgery 208200000X · Primary
In this directory
Locations and evidence
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Practice location
EVERETT, WA, 982086642
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.