| Organization Name: | PROVIDENCE HEALTH & SERVICES - WA |
| NPI Number: | 1770877227 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAULA WOOD (PROVIDER CONCIERGE) |
| Mailing Address: | 1830 Bickford Ave Suite 211 Snohomish |
| State: | WA US |
| Postal Code: | 982901749 |
| Phone Number: | 3606681820 |
| Fax Number: | 3606681825 |
| NPI Enumeration Date: | 06/01/2011 |
| NPI Last Update Date: | 05/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |