Provider Demographics
NPI:1861708281
Name:SWEDISH EDMONDS
Entity type:Organization
Organization Name:SWEDISH EDMONDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECREATRY FOR ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:425-358-9786
Mailing Address - Street 1:21911 76TH AVE W.
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7507
Mailing Address - Country:US
Mailing Address - Phone:425-640-4950
Mailing Address - Fax:425-640-4455
Practice Address - Street 1:21911 76TH AVE W
Practice Address - Street 2:SUITE 110
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7507
Practice Address - Country:US
Practice Address - Phone:425-640-4950
Practice Address - Fax:425-640-4903
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SWEDISH EDMONDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-23
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty