1982771135 NPI number — PHYSICIANS HOSPITAL SERVICES II. PLLC

Table of content: (NPI 1982771135)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982771135 NPI number — PHYSICIANS HOSPITAL SERVICES II. PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHYSICIANS HOSPITAL SERVICES II. PLLC
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:
1982771135
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 48077
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:
98148-0077
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-244-8100
Provider Business Mailing Address Fax Number:
206-431-9142

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12101 AMBAUM BOULEVARD SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-244-8100
Provider Business Practice Location Address Fax Number:
206-431-9142
Provider Enumeration Date:
11/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
WALTER
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
206-244-8100

Provider Taxonomy Codes

  • Taxonomy code: 284300000X , with the licence number:  2084A0401X , 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)

  • Identifier: S592 . This is a "REGENCE" identifier . This identifiers is of the category "OTHER".




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