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1346280922

NPI Code Detail

MEDICARE: PUBLIC HOSPITAL DISTRICT NO. 4, KING COUNTY WASHINGTON

MEDICARE: PUBLIC HOSPITAL DISTRICT NO. 4, KING COUNTY WASHINGTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician
2	225100000X	Physical Therapist
3	235Z00000X	Speech-Language Pathologist
4	363LG0600X	Gerontology Nurse Practitioner
5	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician
6	2084P0800X	Psychiatry Physician
7	207QG0300X	Geriatric Medicine (Family Medicine) Physician
8	207R00000X	Internal Medicine Physician	602 427 233	WA
9	207RC0000X	Cardiovascular Disease Physician
10	104100000X	Social Worker
11	225X00000X	Occupational Therapist
12	207RG0100X	Gastroenterology Physician
13	363LF0000X	Family Nurse Practitioner
14	208100000X	Physical Medicine & Rehabilitation Physician
15	207QA0505X	Adult Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0046971	OTHER	WA	L & I HOSPITAL
2	8918723	OTHER	WA	L & I CRIME HOSPITAL

General Provider Information

NPI Number	:	1346280922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUBLIC HOSPITAL DISTRICT NO. 4, KING COUNTY WASHINGTON

Provider Business Mailing Address
First Line	:	9801 FRONTIER AVE SE
Second Line	:
City	:	SNOQUALMIE
State	:	WA
Zip	:	98065-5200
Country	:	US
Telephone Number	:	425-831-2321
Fax Number	:	425-689-1306

Provider Business Practice Location Address
First Line	:	9801 FRONTIER AVE SE
Second Line	:
City	:	SNOQUALMIE
State	:	WA
Zip	:	98065-5200
Country	:	US
Telephone Number	:	425-831-2300
Fax Number	:	425-831-2361

Authorized Official
Title or Position	:	MSS & PE MANAGER
Name	:	BARBI DONOVAN
Credential	:
Telephone Number	:	425-831-2321

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	12/16/2025

Similar Medicare Providers

1487644563 — DR. NOEL THEODORE JOHNSON D.O.
Practice Location Address:

9801 FRONTIER AVE SE
SNOQUALMIE, WA
98065-5200

Practice Phone: 425-831-2300
Practice Fax:

1497715791 — YEN S CHEN MD
Practice Location Address:

9801 FRONTIER AVE SE
SNOQUALMIE, WA
98065-5200

Practice Phone: 425-831-2321
Practice Fax:

1194772046 — KIMBERLY WITKOP M.D.
Practice Location Address:

9801 FRONTIER AVE SE
SNOQUALMIE, WA
98065-5200

Practice Phone: 425-831-2300
Practice Fax: 425-831-2361

1548209091 — ALAN RICHARD CHOCK MD
Practice Location Address:

9801 FRONTIER AVE SE
SNOQUALMIE, WA
98065-5200

Practice Phone: 425-831-2300
Practice Fax: 425-831-2361

1477592038 — KAREN BETTY TOM M.D.
Practice Location Address:

9801 FRONTIER AVE SE
SNOQUALMIE, WA
98065-5200

Practice Phone: 425-831-2321
Practice Fax: 425-831-2361

1518907369 — JOHN TODD HUTTENLOCHER MD
Practice Location Address:

9801 FRONTIER AVE SE
SNOQUALMIE, WA
98065-5200

Practice Phone: 425-831-2300
Practice Fax: 425-831-2361

Directions to “PUBLIC HOSPITAL DISTRICT NO. 4, KING COUNTY WASHINGTON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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