Provider Demographics
NPI:1407167513
Name:PUBLIC HOSPITAL DISTRICT 2 OF SNOHOMISH COUNTY
Entity Type:Organization
Organization Name:PUBLIC HOSPITAL DISTRICT 2 OF SNOHOMISH COUNTY
Other - Org Name:STEVENS PAIN TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DABLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-673-3374
Mailing Address - Street 1:PO BOX 91000
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-2100
Mailing Address - Country:US
Mailing Address - Phone:425-673-3374
Mailing Address - Fax:425-640-4455
Practice Address - Street 1:21601 76TH AVE W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7507
Practice Address - Country:US
Practice Address - Phone:425-640-4000
Practice Address - Fax:425-640-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-24
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain