Healthcare Provider Details

I. General information

NPI: 1194237131
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: 10/31/2017
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35020 SE KINSEY ST
SNOQUALMIE WA
98065-8992
US

IV. Provider business mailing address

35020 SE KINSEY ST
SNOQUALMIE WA
98065-8992
US

V. Phone/Fax

Practice location:
  • Phone: 425-396-7682
  • Fax: 425-396-7694
Mailing address:
  • Phone: 425-831-2300
  • Fax: 425-831-2361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberH195
License Number StateWA

VIII. Authorized Official

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