Healthcare Provider Details
I. General information
NPI: 1699967174
Provider Name (Legal Business Name): DEPARTMENT OF VETERANS AFFAIRS PUGET SOUND HEALTH CARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2007
Last Update Date: 08/17/2007
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
- Phone: 206-277-1027
- Fax: 206-764-2192
- Phone: 206-277-1027
- Fax: 206-764-2192
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305S00000X |
| Taxonomy | Point of Service |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
LINDSEY
EITH
PARRISH NELSON
Title or Position: SOCIAL WORKER
Credential: MSW
Phone: 206-277-1027