Provider Demographics
NPI:1306694732
Name:PROVIDENCE HEALTH & SERVICES-WASHINGTON
Entity type:Organization
Organization Name:PROVIDENCE HEALTH & SERVICES-WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERRE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:425-261-4780
Mailing Address - Street 1:1801 LIND AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3368
Mailing Address - Country:US
Mailing Address - Phone:425-261-4780
Mailing Address - Fax:
Practice Address - Street 1:1615 75TH ST SW STE 210
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-6293
Practice Address - Country:US
Practice Address - Phone:425-261-4780
Practice Address - Fax:425-261-4720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty