Healthcare Provider Details

I. General information

NPI: 1558869289
Provider Name (Legal Business Name): PUBLIC HOSPITAL DISTRICT NO 4 KING COUNTY WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2018
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 Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

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