=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770743528
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SWEDISH HEALTH SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2008
-----------------------------------------------------
Last Update Date | 05/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 BROADWAY
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98122-5330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-215-9011
-----------------------------------------------------
Fax | 206-215-9120
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601 BROADWAY
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98122-5330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-215-9011
-----------------------------------------------------
Fax | 206-215-9120
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ASSISTANT SECREATRY FOR ENROLLMENT
-----------------------------------------------------
Name | DONALD WAYNE ANDERSON JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 425-358-9786
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PHAR.CF.60021722
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------