Healthcare Provider Details

I. General information

NPI: 1760641252
Provider Name (Legal Business Name): VETERANS AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 06/09/2008
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

11633 NE 92ND ST
KIRKLAND WA
98033-5703
US

V. Phone/Fax

Practice location:
  • Phone: 206-764-2101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License NumberRN00176036
License Number StateWA

VIII. Authorized Official

Name: CAROL WIELTSCHNIG
Title or Position: NURSE RECRUITER
Credential:
Phone: 206-764-2487