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General NPI Number Information
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NPI Number | 1689827321
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Entity Type | Organization
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Legal Business Name | PROVIDENCE HEALTH & SERVICES - WASHINGTON
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 2811 S 102ND ST SUITE 220
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City | SEATTLE
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State | WA
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Zip | 98168-1870
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Country | US
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Telephone | 206-320-4000
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Fax | 206-320-2280
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Provider Business Mailing Address
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Address Line | PO BOX 94511
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City | SEATTLE
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State | WA
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Zip | 98124-6811
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECRETARY ENROLLMENT
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Name | DONALD W ANDERSON JR.
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Credential |
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Telephone | 425-358-9786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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