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NPI Code Detail

MEDICARE: PROVIDENCE HEALTH & SERVICES WASHINGTON

MEDICARE: PROVIDENCE HEALTH & SERVICES WASHINGTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living FacilityBH-198WA
2314000000XSkilled Nursing Facility77WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952386369
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROVIDENCE HEALTH & SERVICES WASHINGTON
Provider Business Mailing Address
First Line : 4831 35TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98126-2709
Country : US
Telephone Number : 206-937-3700
Fax Number : 206-938-8999
Provider Business Practice Location Address
First Line : 4831 35TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98126-2709
Country : US
Telephone Number : 206-937-3700
Fax Number : 206-938-8999
Authorized Official
Title or Position : ASSISTANT SECRETARY ENROLLMENT
Name : DONALD W ANDERSON JR.
Credential :
Telephone Number : 425-358-9786
Provider Enumeration Date : 12/08/2005
Last Update Date : 05/16/2025

Similar Medicare Providers

1174661805 — MICHEAL HENRY PD
Practice Location Address:
4831 35TH AVE SW
SEATTLE, WA
98126-2709
Practice Phone: 206-938-6196
Practice Fax:
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Practice Location Address:
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1366634503 — SISTERS OF PROVIDENCE IN WASHINGTON
Practice Location Address:
4831 35TH AVE SW
SEATTLE, WA
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1457601932 — MS. HILLARY DANIELLE RICHARDSON OTR/L
Practice Location Address:
4831 35TH AVE SW
SEATTLE, WA
98126-2709
Practice Phone: 206-923-3940
Practice Fax:
1639601180 — DR. ELYCE ANNE OPHEIM MD
Practice Location Address:
4831 35TH AVE SW
SEATTLE, WA
98126-2709
Practice Phone: 206-923-3940
Practice Fax: 206-923-3904
1467972091 — CARLEY RISSMAN
Practice Location Address:
4831 35TH AVE SW
SEATTLE, WA
98126-2709
Practice Phone: 206-937-3700
Practice Fax:

Directions to “PROVIDENCE HEALTH & SERVICES WASHINGTON ” Practice Location

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