Healthcare Provider Details

I. General information

NPI: 1093812166
Provider Name (Legal Business Name): PROVIDENCE HOSPICE AND HOME CARE OF SNOHOMISH COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2731 WETMORE AVE SUITE 520
EVERETT WA
98201-3571
US

IV. Provider business mailing address

2731 WETMORE AVE SUITE 520
EVERETT WA
98201-3571
US

V. Phone/Fax

Practice location:
  • Phone: 425-261-4800
  • Fax:
Mailing address:
  • Phone: 425-261-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PAULA S BEATTY
Title or Position: EXECUTIVE DIRECTOR
Credential: RN BSN
Phone: 425-261-4800