Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Critical Access |
282NC0060X | A0[7] | Critical Access Hospital | |
Long Term Care Pharmacy |
3336L0003X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1629054374 |
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| LBN Legal business name | PROVIDENCE HEALTH & SERVICES WASHINGTON | ||||
| Authorized official | DONALD ANDERSON - (ASSISTANT SECRETARY OF ENROLLMENTS) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 12/15/2005 | ||||
| Last updated | 05/13/2025 - More than a year ago | ||||
| Identifiers |
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