| Organization Name: | PROVIDENCE HEALTH & SERVICES WASHINGTON |
| NPI Number: | 1255685822 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SEAN M DOUGLAS (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 1200 E Columbia Ave Colville |
| State: | WA US |
| Postal Code: | 991143354 |
| Phone Number: | 5094742072 |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2012 |
| NPI Last Update Date: | 10/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |