Healthcare Provider Details

I. General information

NPI: 1144432634
Provider Name (Legal Business Name): PUBLIC HOSPITAL DISTRICT NO 4, KING COUNTY WA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 FRONTIER AVE SE
SNOQUALMIE WA
98065-5200
US

IV. Provider business mailing address

9801 FRONTIER AVE SE
SNOQUALMIE WA
98065-5200
US

V. Phone/Fax

Practice location:
  • Phone: 425-831-2321
  • Fax:
Mailing address:
  • Phone: 425-831-2300
  • Fax: 425-689-1306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateWA
# 8
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BARBI DONOVAN
Title or Position: MSS & PE MANAGER
Credential:
Phone: 425-831-2321