Provider Demographics
NPI:1972927267
Name:PROVIDENCE HEALTH & SERVICES - WA
Entity Type:Organization
Organization Name:PROVIDENCE HEALTH & SERVICES - WA
Other - Org Name:PROVIDENCE LIFELINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP CHIEF EXECTUVE SR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HELLRIGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-254-5432
Mailing Address - Street 1:PO BOX 94349
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-6649
Mailing Address - Country:US
Mailing Address - Phone:425-261-4800
Mailing Address - Fax:425-261-4819
Practice Address - Street 1:2731 WETMORE AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3571
Practice Address - Country:US
Practice Address - Phone:425-261-4800
Practice Address - Fax:425-261-4819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies