Healthcare Provider Details

I. General information

NPI: 1053362327
Provider Name (Legal Business Name): SWEDISH HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 BROADWAY
SEATTLE WA
98122-4379
US

IV. Provider business mailing address

PO BOX 84026
SEATTLE WA
98124-8426
US

V. Phone/Fax

Practice location:
  • Phone: 206-215-2520
  • Fax: 206-986-3180
Mailing address:
  • Phone: 206-320-4933
  • Fax: 206-320-4194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number600663819
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number600663819
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number600663819
License Number StateWA

VIII. Authorized Official

Name: DONALD WAYNE ANDERSON JR.
Title or Position: ASSISTANT SECREATRY FOR ENROLLMENT
Credential:
Phone: 425-358-9786