| Organization Name: | PROVIDENCE HEALTH & SERVICES - WASHINGTON |
| NPI Number: | 1053562876 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN COLUMBER (DIR OF REVENUE CYCLE MANAGEMENT) |
| Mailing Address: | 380 Chase Ave Walla Walla |
| State: | WA US |
| Postal Code: | 993622924 |
| Phone Number: | 5095225900 |
| Fax Number: | 5095225578 |
| NPI Enumeration Date: | 10/10/2008 |
| NPI Last Update Date: | 06/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | H-050 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |