MEDICARE: PUBLIC HOSPITAL DISTRICT NO 2 OF KING COUNTY

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	3336C0003X	Community/Retail Pharmacy	CF58450	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4931754	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1598731051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUBLIC HOSPITAL DISTRICT NO 2 OF KING COUNTY

Provider Business Mailing Address
First Line	:	11800 NE 128TH ST
Second Line	:	STE 150
City	:	KIRKLAND
State	:	WA
Zip	:	98034-7208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11800 NE 128TH ST
Second Line	:	STE 150
City	:	KIRKLAND
State	:	WA
Zip	:	98034-7208
Country	:	US
Telephone Number	:	425-899-2808
Fax Number	:	425-899-2809

Authorized Official
Title or Position	:	MGR
Name	:	RICHARD MOLITOR
Credential	:	RPH
Telephone Number	:	425-899-2808

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	01/29/2009

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Directions to “PUBLIC HOSPITAL DISTRICT NO 2 OF KING COUNTY ” Practice Location

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