Healthcare Provider Details

I. General information

NPI: 1902907165
Provider Name (Legal Business Name): KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 214TH ST SE SUITE 110
BOTHELL WA
98021-8486
US

IV. Provider business mailing address

PO BOX 102928
PASADENA CA
91189-2928
US

V. Phone/Fax

Practice location:
  • Phone: 425-488-4988
  • Fax: 425-488-4993
Mailing address:
  • Phone: 425-899-3868
  • Fax: 425-899-3269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierCG2833
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerMEDICARE RAILROAD
# 2
Identifier7072358
Identifier TypeMEDICAID
Identifier StateWA
Identifier Issuer
# 3
IdentifierCJ9678
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerMEDICARE RAILROAD
# 4
IdentifierCQ2437
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerMEDICARE RAILROAD
# 5
IdentifierCG8137
Identifier TypeOTHER
Identifier StateWA
Identifier IssuerMEDICARE RAILROAD

VIII. Authorized Official

Name: WILLIAM HOWE
Title or Position: CFO
Credential:
Phone: 425-899-2606