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General NPI Number Information
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NPI Number | 1083912257
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Entity Type | Organization
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Legal Business Name | WASHINGTON STATE DEPARTMENT OF HEALTH
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 1610 NE 150TH ST
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City | SHORELINE
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State | WA
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Zip | 98155-7224
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Country | US
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Telephone | 206-418-5400
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Fax | 206-418-5445
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Provider Business Mailing Address
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Address Line | 1610 NE 150TH ST
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City | SHORELINE
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State | WA
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Zip | 98155-7224
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Country | US
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Telephone | 206-418-5400
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Fax | 206-418-5445
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Authorized Official
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Title or Position | ASST. SECRETARY FINANCIAL SERVICES
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Name | LOIS SPEELMAN
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Credential |
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Telephone | 360-236-4503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | MTSA.FS.00001327
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License Number State | WA
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