Healthcare Provider Details

I. General information

NPI: 1497757207
Provider Name (Legal Business Name): COUNTY OF PIERCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3580 PACIFIC AVE
TACOMA WA
98418-7915
US

IV. Provider business mailing address

3580 PACIFIC AVE
TACOMA WA
98418-7915
US

V. Phone/Fax

Practice location:
  • Phone: 253-798-4500
  • Fax:
Mailing address:
  • Phone: 253-798-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License NumberPH-020
License Number StateWA

VIII. Authorized Official

Name: MR. DAVID E. STEWART
Title or Position: DIRECTOR OF HUMAN SERVICES
Credential:
Phone: 253-798-4500