Healthcare Provider Details

I. General information

NPI: 1104959097
Provider Name (Legal Business Name): BHC FAIRFAX HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10200 NE 132ND ST
KIRKLAND WA
98034-2831
US

IV. Provider business mailing address

10200 NE 132ND ST
KIRKLAND WA
98034-2831
US

V. Phone/Fax

Practice location:
  • Phone: 425-821-2000
  • Fax:
Mailing address:
  • Phone: 425-821-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: PEGGY TRACHTE
Title or Position: BUSINESS OFFICE DIRECTOR
Credential:
Phone: 425-284-1708