Healthcare Provider Details

I. General information

NPI: 1982962148
Provider Name (Legal Business Name): VETERANS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 04/25/2012
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

10426 65TH AVE S
SEATTLE WA
98178-2505
US

V. Phone/Fax

Practice location:
  • Phone: 206-854-9757
  • Fax:
Mailing address:
  • Phone: 206-854-9757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License NumberRN00106472
License Number StateWA

VIII. Authorized Official

Name: MRS. DEBORAH ANN BUTLER
Title or Position: REGISTERED NURSE
Credential:
Phone: 206-854-9757