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General NPI Number Information
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NPI Number | 1952386369
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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 | 12/08/2005
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 4831 35TH AVE SW
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City | SEATTLE
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State | WA
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Zip | 98126-2709
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Country | US
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Telephone | 206-937-3700
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Fax | 206-938-8999
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Provider Business Mailing Address
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Address Line | 4831 35TH AVE SW
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City | SEATTLE
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State | WA
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Zip | 98126-2709
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Country | US
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Telephone | 206-937-3700
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Fax | 206-938-8999
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | BH-198
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 77
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License Number State | WA
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