PROVIDENCE HEALTHCARE NPI 1417148461

NPI Information

NPI: 1417148461
Provider Name: PROVIDENCE HEALTHCARE

Doing Business As: DEER PARK HOSPITAL CRNA

Classification: General Acute Care Hospital - 282NR1301X
Entity Type: Organization

Specialization: Rural

Address:
1015 E D ST
DEER PARK, WA
ZIP 99006
Phone: (509) 232-1173
Get Directions

PROVIDENCE HEALTHCARE is a rural general acute care hospital in Deer Park, WA. PROVIDENCE HEALTHCARE NPI is 1417148461. The provider is registered as an organization entity type.
The provider Is Doing Business As Deer Park Hospital Crna.

The provider's business location address is:

1015 E D ST
DEER PARK, WA
ZIP 99006-067
Phone: (509) 232-1173
Fax: (509) 232-1165

The provider's authorized official is Debbie L Wicklund .
The authorized official title is Director Of Finance and has the following contact phone number (509) 232-1177.

The enumeration date for this NPI number is 8/6/2007 and was last updated on 10/30/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	282NR1301X	General Acute Care Hospital	Rural	H 178	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	H 178	OTHER	WASHINGTON	LICENSE
2	9043233	MEDICAID	WASHINGTON
3	000015	OTHER	WASHINGTON	FACILITY ID
4	GAB02213	MEDICARE PIN	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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