Healthcare Provider Details
I. General information
NPI: 1225085285
Provider Name (Legal Business Name): SWEDISH HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2006
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
747 BROADWAY
SEATTLE WA
98122-4379
US
IV. Provider business mailing address
PO BOX 84026
SEATTLE WA
98124-8426
US
V. Phone/Fax
- Phone: 206-215-2700
- Fax: 206-215-2702
- Phone: 206-320-4476
- Fax: 206-320-3301
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | 600663819 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0203X |
| Taxonomy | Pediatric Critical Care Medicine Physician |
| License Number | 600663819 |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 600663819 |
| License Number State | WA |
VIII. Authorized Official
Name:
DONALD
WAYNE
ANDERSON
JR.
Title or Position: ASSISTANT SECREATRY FOR ENROLLMENT
Credential:
Phone: 425-358-9786