1487671020 NPI number — PUBLIC HOSPITAL DISTRICT #1 OF KING COUNTY

Table of content: (NPI 1487671020)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487671020 NPI number — PUBLIC HOSPITAL DISTRICT #1 OF KING COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PUBLIC HOSPITAL DISTRICT #1 OF KING COUNTY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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 Information

NPI Number:
1487671020
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 LIND AVE SW
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
RENTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98057-4934
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-656-5412
Provider Business Mailing Address Fax Number:
425-656-4079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4033 TALBOT RD S
Provider Second Line Business Practice Location Address:
STE 430
Provider Business Practice Location Address City Name:
RENTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98055-5772
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-227-0231
Provider Business Practice Location Address Fax Number:
425-227-0177
Provider Enumeration Date:
07/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BERNSTEIN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
I
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
425-656-5536

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  H-155 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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