Organization Name: | PROVIDENCE HEALTH & SERVICES WASHINGTON |
NPI Number: | 1619176997 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARCELLA H NICOL (RCM DIRECTOR) |
Mailing Address: | 413 Lilly Rd Ne Olympia |
State: | WA US |
Postal Code: | 985065133 |
Phone Number: | 3604919480 |
Fax Number: | |
NPI Enumeration Date: | 07/16/2007 |
NPI Last Update Date: | 10/12/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |