National Provider Identifier Database

SOUTH CORRECTIONAL ENTITY
Prison Health


Contact Information

SOUTH CORRECTIONAL ENTITY
20817 17TH AVE S
DES MOINES, WA98198-7665
Phone: 206-257-6200
Fax:
Website:
Specialty Taxonomy Code
* Prison Health 261QP2400X

* Indicates primary specialty

NPI Profile & details for SOUTH CORRECTIONAL ENTITY

NPI Number 1851198212
Legal business name
LBN
SOUTH CORRECTIONAL ENTITY
Authorized official DEVON SCHRUM - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 02/25/2025
Last updated 02/25/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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