Healthcare Provider Details

I. General information

NPI: 1396088340
Provider Name (Legal Business Name): HEWITT PATIENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11820 NORTHUP WAY SUITE E226
BELLEVUE WA
98005-1946
US

IV. Provider business mailing address

11820 NORTHUP WAY SUITE E226
BELLEVUE WA
98005-1946
US

V. Phone/Fax

Practice location:
  • Phone: 206-552-6992
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP60326001
License Number StateWA

VIII. Authorized Official

Name: OLIVIA BOWEN
Title or Position: MANAGER
Credential:
Phone: 206-941-0945