Provider Demographics
NPI:1629245865
Name:PUBLIC HOSPITAL DISTRICT #1 OF KING COUNTY
Entity Type:Organization
Organization Name:PUBLIC HOSPITAL DISTRICT #1 OF KING COUNTY
Other - Org Name:VALLEY URGENT CARE CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-228-3440
Mailing Address - Street 1:PO BOX 34876
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1876
Mailing Address - Country:US
Mailing Address - Phone:425-656-5412
Mailing Address - Fax:425-656-4079
Practice Address - Street 1:10555 SE CARR RD
Practice Address - Street 2:STE M
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5820
Practice Address - Country:US
Practice Address - Phone:425-656-4270
Practice Address - Fax:425-656-4271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAH-155207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty