Healthcare Provider Details

I. General information

NPI: 1942130125
Provider Name (Legal Business Name): COMMONSPIRIT WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11511 CANTERWOOD BLVD STE 220
GIG HARBOR WA
98332-5818
US

IV. Provider business mailing address

PO BOX 31001 1489
PASADENA CA
91110-0001
US

V. Phone/Fax

Practice location:
  • Phone: 253-530-2066
  • Fax:
Mailing address:
  • Phone: 253-530-2066
  • Fax: 253-530-2625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAVID NOSACKA
Title or Position: CFO
Credential:
Phone: 253-680-4005