Healthcare Provider Details

I. General information

NPI: 1053327890
Provider Name (Legal Business Name): BHC FAIRFAX HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 03/15/2011
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: 425-814-0301
Mailing address:
  • Phone: 425-821-2000
  • Fax: 425-814-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License NumberPH004
License Number StateWA

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: SR VP CFO
Credential:
Phone: 610-768-3300