1730687161 NPI number — MULTICARE HEALTH SYSTEM

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730687161 NPI number — MULTICARE HEALTH SYSTEM

Employer Identification Number (EIN):

Provider Organization Name:

MULTICARE HEALTH SYSTEM

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

MULTICARE ROCKWOOD CLINIC

Provider Other Organization Name Type Code:

3

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1730687161

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

01/31/2018

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 34697

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SEATTLE

Provider Business Mailing Address State Name:

WA

Provider Business Mailing Address Postal Code:

98124-1697

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

400 E 5TH AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

SPOKANE

Provider Business Practice Location Address State Name:

WA

Provider Business Practice Location Address Postal Code:

99202-1334

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

509-838-2531

Provider Business Practice Location Address Fax Number:

509-455-5315

Provider Enumeration Date:

01/31/2018

Authorized Official Last Name:

LOOMIS

Authorized Official First Name:

ANNA

Authorized Official Middle Name:

Authorized Official Title or Position:

SR VP-CHIEF FINANCIAL OFFICE

Authorized Official Telephone Number:

253-403-8020

• Taxonomy code: 1041C0700X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 111N00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 133V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 152W00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207Q00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207R00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 207W00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2084N0400X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0001X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 213ES0103X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 225100000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 225700000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 225X00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 363A00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 363L00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .