National Provider Identifier Database

PROVIDENCE HEALTH SERVICES WASHINGTON
Long Term Care Pharmacy

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.


Contact Information

PROVIDENCE HEALTH & SERVICES WASHINGTON
3333 S 120TH PL STE 100B
TUKWILA, WA98168-5134
Phone: 425-687-4400
Fax: 425-687-4401
Website:
Specialty Taxonomy Code
* Long Term Care Pharmacy 3336L0003X
Clinic Pharmacy 3336C0002X
Clinical Pharmacology 208U00000X
Community/Retail Pharmacy 3336C0003X
Compounding Pharmacy 3336C0004X
Home Infusion Therapy Pharmacy 3336H0001X
Managed Care Organization Pharmacy 3336M0003X
Pharmacy 333600000X
Specialty Pharmacy 3336S0011X

* Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH & SERVICES WASHINGTON

NPI Number 1720121346
Legal business name
LBN
PROVIDENCE HEALTH & SERVICES WASHINGTON
Authorized official DONALD ANDERSON - (ASSISTANT SECRETARY OF ENROLLMENTS)
Entity Organization
Organization subpart No
Enumeration date 02/14/2007
Last updated 05/16/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • WA License #: CF00056548

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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