Healthcare Provider Details

I. General information

NPI: 1982771135
Provider Name (Legal Business Name): PHYSICIANS HOSPITAL SERVICES II. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12101 AMBAUM BOULEVARD SW
SEATTLE WA
98146
US

IV. Provider business mailing address

PO BOX 48077
SEATTLE WA
98148-0077
US

V. Phone/Fax

Practice location:
  • Phone: 206-244-8100
  • Fax: 206-431-9142
Mailing address:
  • Phone: 206-244-8100
  • Fax: 206-431-9142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number2084A0401X
License Number StateWA

VIII. Authorized Official

Name: DR. JAMES WALTER SMITH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 206-244-8100