| Organization Name: | PROVIDENCE EVERETT MEDICAL CENTER |
| NPI Number: | 1073773198 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOYCE KOBAYASHI (DIR REVENUE CYCLE MGMT NWSA) |
| Mailing Address: | 4112 Harbour Pointe Blvd Suite 100 Mukilteo |
| State: | WA US |
| Postal Code: | 982754700 |
| Phone Number: | 4253476334 |
| Fax Number: | 4253476335 |
| NPI Enumeration Date: | 06/12/2008 |
| NPI Last Update Date: | 09/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |