Healthcare Provider Details

I. General information

NPI: 1700281276
Provider Name (Legal Business Name): VA PUGET SOUND HEALTHCARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2014
Last Update Date: 10/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

1660 S COLUMBIAN WAY
SEATTLE WA
98108-1532
US

V. Phone/Fax

Practice location:
  • Phone: 206-764-2404
  • Fax:
Mailing address:
  • Phone: 206-764-2404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. EMILY HANSON
Title or Position: AUDIOLOGY DEPARTMENT HEAD
Credential: AU.D
Phone: 206-764-2499