Healthcare Provider Details

I. General information

NPI: 1275693244
Provider Name (Legal Business Name): MULTICARE HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17700 SE 272ND ST STE 100
COVINGTON WA
98042-4951
US

IV. Provider business mailing address

17700 SE 272ND ST STE 100
COVINGTON WA
98042-4951
US

V. Phone/Fax

Practice location:
  • Phone: 253-372-7220
  • Fax: 253-372-7221
Mailing address:
  • Phone: 253-372-7220
  • Fax: 253-372-7221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHAR.CF.00004705
License Number StateWA

VIII. Authorized Official

Name: KELLY WILLIAMS
Title or Position: DIRECTOR PROVIDER ENROLLMENT
Credential:
Phone: 253-459-8009