| Organization Name: | PROVIDENCE HEALTH & SERVICES WASHINGTON |
| NPI Number: | 1013905660 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MIKE BUTLER (SVP CFO) |
| Mailing Address: | 1915 E Rezanof Dr Kodiak |
| State: | AK US |
| Postal Code: | 996156602 |
| Phone Number: | 9074863281 |
| Fax Number: | 9074869546 |
| NPI Enumeration Date: | 10/07/2005 |
| NPI Last Update Date: | 01/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | 309115 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |